Draft_Performance_Work_Statement-13_Jun_18.pdf

DRAFT PERFORMANCE WORK STATEMENT

MILITARY ENTRANCE PROCESSING STATION (MEPS)

FEE BASIS PROVIDERS

1 GENERAL

1.1 The contractor shall provide personal services for Fee Basis Providers (FBPs) who shall perform medical histories, physical examinations, reviews of required medical tests and documents pertaining to consultations and medical histories and on occasion determine whether an applicant meets the medical standards on applicants of the Armed Forces at 65 Military Entrance Processing Stations (MEPS) and one remote processing unit, located in Las Vegas, Nevada, herein referred to collectively as MEPS. Refer to Exhibit A for MEPS locations throughout the Continental United States (CONUS), Alaska, Hawaii, and Puerto Rico.

1.2 The contractor shall be fully responsible for all functions in providing fully qualified, professional FBPs to include, but not limited to, all aspects of advertising, recruiting, interviewing, hiring, verification and preparation of credential packets and placement of FBPs in the 66 MEPS locations ready to perform services in accordance with the period of performance dates under this contract. Performance of services shall be in accordance with this Performance Work Statement (PWS), the established principles and ethics of the medical profession. This is a personal services contract and is intended to create an employer-employee relationship between the Government and the individual Fee Basis Providers (FBPs) only to the extent necessary for providing the services for physical medical examinations and testing as required under this contract. The performance of these services by the individual FBPs under a personal services contract are subject to day-to-day performance oversight and control by the MEPS Chief Medical Officer (CMO) or designated representative comparable to that exercised over military and civil service providers engaged in comparable services The day-to-day performance oversight and control shall include FBP participation in a local medical peer review in accordance with USMEPCOM Regulation 40-2, Medical Services Provider Quality Management Program (PQMP). Any personal injury claims alleging negligence by the individual FBPs within the scope of the FBP’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 providers. 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 FBP may be associated.

The authority for this contract is 10 United States Code 1089 and 10 United States Code 1091.

1.3 BACKGROUND. The mission of USMEPCOM is to process applicants for the Armed Forces of the United States. The Command administers medical examinations annually at 66 MEPS locations to support the mission of the Armed Forces’ recruiting services for the Departments of the Army, Navy, Air Force, Marine Corps, Coast Guard and other federal organizations. Each MEPS employs one government physician known as the MEPS CMO.

The CMO works under the supervision of the MEPS Commander. Several larger MEPS also have assistant CMOs (ACMOs) which are also government physicians. FBPs supplement these government physicians based on the daily workload of applicants being processed at each individual MEPS. CMOs, ACMOs and FBPs (profilers) use their professional training and judgment to apply medical qualification standards set forth by DoD policy in order to certify that, in their professional opinion, applicants either meet or fail to meet set medical standards. The certification that applicants meet medical standards is then transmitted through the MEPS Commander to the Armed Forces.

1.4 SCOPE OF WORK. The Contractor shall provide qualified, professional personnel to perform the following services: medical pre-screening; medical histories; physical examinations; reviews of required medical tests and documents pertaining to consultations and medical histories; assessing applicant medical documentation and rendering their medical opinion on an applicant’s medical qualification for serving in the Armed Forces. This shall be in accordance with qualification standards set forth by DoD policy under the general supervision of the MEPS CMO or designated representative. The contractor shall also provide medical expertise in the MEPS medical department during CMO and ACMO absences, if authorized as a Fee Basis CMO (FB-CMO) under the guidance of the MEPS Commander and/or MEPS Operations Officer. When performing as the FB-CMO, the FBP shall attend the local inter-service recruiting council meeting as required to discuss MEPS specific medical issues when requested by the MEPS Commander. The FB-CMO shall provide technical advice and guidance to the MEPS medical department when requested by the MEPS Commander or medical staff. Medical processing questions shall be directed to a HQ USMEPCOM physician.

1.4.1 The FB-CMO shall be a qualified, Defined Provider Category (DPC) Level 4 physician approved by the USMEPCOM Command Surgeon/J-7/Medical Director (or designated representative) and USMEPCOM Regulation 40-2, to serve as a FB-CMO. While serving in the role of FB-CMO, the FB-CMO shall provide medical/technical guidance in the MEPS or processing site medical department in conjunction with the MEPS Operations Officer, leading the local medical peer review, requesting consultations, and attending meetings as requested by the MEPS Commander. The FBP shall not have the authority to supervise or give administrative direction to MEPS or processing facility personnel.

1.4.2 The contractor shall comply with USMEPCOM Regulations 40-1, Medical Services, Medical Qualification Program, 40-2, Medical Services PQMP, and other DoD and USMEPCOM policies and procedures. The contractor shall comply with all applicable laws, rules and regulations, including but not limited to those included in Section 6 of the PWS.

1.5 The MEPS Commander will serve as the administrative authority, but all medical processing questions shall be directed to a HQ USMEPCOM physician. Contract employees consult with the CMO/ACMOs as needed, and with colleagues to develop knowledge and apply agency policies and practices to new matters. His/her work shall be reviewed by the government personnel for technical adequacy and conformance with procedures and practices applicable to laws, rules and regulations, and government reviews/evaluations shall be forwarded to the Contractor on a regular basis to ensure Contractor has sufficient feedback for proper supervision and control of the contract employee.

1.6 Medical Malpractice for Personal Services. Title 10, Section 1089, USC, Defense of Certain Suits Arising Out of Medical Malpractice, shall apply to personal injury lawsuits filed against FBPs based on negligent or wrongful acts or omissions incident to performance within the scope of this contract. This personal services relationship is solely between the Government and FBPs and does not include the prime contractors. Therefore, prime contractors are responsible for their own insurance and liability of any type. FBPs are not required to maintain medical malpractice liability insurance while performing services under this contract.

1.7 SAFETY REQUIREMENTS. The Contractor shall maintain safety and health standards compliant with requirements of the Occupational Safety and Health Administration (OSHA).

1.7.1 CRIME CONTROL ACT OF 1990. No performance under this contract will be allowed without full compliance with the Crime Control Act of 1990 and Department of Defense Instruction 1402.5 dated 19 January 1993. All FBPs having access to Government computer systems and/or providing care to children (17 years of age and under) must be subject of a favorable background investigation/national agency check to be processed by the Government with their credentials package. Background checks will be based on fingerprints of FBPs obtained by a law enforcement officer or at a FBPs local MEPS and inquiries will be made, based on the Standard Form 85 and Optional Form 306 completed by the FBP through the Federal Bureau of Investigation (FBI). Completed Standard Forms 85 and Optional Form 306 and two fingerprint cards will be submitted to USMEPCOM by the Contractor in the FBP’s credential package. The contractor shall ensure that FBPs comply with required background check requirements and timelines as established by the Electronic Questionnaires Processing system.

1.8 If the Contractor receives or discovers information that a Contractor employee has been arrested or charged with a criminal offense that could result in license or certification suspension or revocation, or disqualification/denial of a satisfactory background check review under DODI 1402.5, the Contractor shall not allow or permit the employee to work until the Contracting Officer determines that the return of the Contractor employee to the work site is appropriate. Examples of such offenses include, but are not limited to, offenses of moral turpitude; harm to a child;

acts of physical or domestic violence; illegal possession or use of a weapon; reckless and negligent driving; driving under the influence of alcohol or drugs; or possession or use of a controlled substances. The Contractor shall notify HQ-J7 Contracting Officer Representative (COR) within 24 hours of discovery.

1.9 SECURITY REQUIREMENTS. The Contractor and any FBPs working in the MEPS shall adhere to the MEPS local policies regarding the security of applicant information.

1.10 Contractor Orientation. All contractor employees shall make an effort to complete a MEPS orientation visit, prior to performing services under this contract. MEPS orientation must occur within five (5) duty days of beginning work at the MEPS or processing site. The purpose of this visit is for the FBP to become familiar with the MEPS environment and medical processes, it is not intended to be an interview.

1.11 FBP Meeting Attendance. Contractor employees shall attend local professional medical/staff meetings and participate in peer review and clinical quality control/performance improvement activities, to include review and evaluation meetings dealing with medical applicant processing.

1.12 Communication. Contractor employees shall maintain open and professional communication with members of the MEPS staff, customers, and other contractor employees. The COR will report MEPS complaints in writing to the KO for action. MEPS complaints will be considered a performance failure. The contractor shall resolve all substantiated complaints immediately upon notification of the complaint, and no later than the suspense date provided by the KO, or designated representative. The Contractor shall ensure effective interface and communication with government personnel to ensure no interruption of services or government mission.

1.13 Neither the Contractor nor any of its FBPs shall disclose or cause to disseminate any information concerning operations of military activities. Such action(s) may result in violation of the contract and possible legal actions.

1.14 All inquiries, comments or complaints arising from any matter observed, experienced, or learned of as a result of or in connection with the performance of this contract, the resolution of which may require the dissemination of official information, shall be directed to the COR and the contracting officer.

1.15 The Contractor shall only conduct business with designated government personnel listed as points of contact (POCs). The Government will provide names, e-mail addresses, and phone numbers of authorized personnel to the Contractor, in writing, within 10 days of contract award and updated as necessary throughout the contract period.

Information will be given to the contractor upon any changes of POCs.

1.16 U.S. Government records, copies of original results and reports, verified original data, corrected data, and corrected supporting final reports are maintained by USMEPCOM and remain the property of the U.S. Government.

These files/results, such as PQMP credentials paperwork, licenses, applications, resumes, letters of recommendation, certified true copies of diplomas, Basic Life Support (BLS), prime source verification, and licensure reports, must be surrendered to the COR upon contract expiration, completion, or termination.

1.17 Trusted Associated Sponsorship System (TASS)

1.17.1 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.

1.17.2 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.

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

1.17.4 The Contractor is responsible for absences of FBPs 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.

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

1.17.6 The USG will sponsor the contract FBP’s for an Army Knowledge Online (AKO) account. All CSP e-mail addresses will identify them as a Contractor and use the format firstname.lastname.ctr@us.army.mil. The USG will discontinue the AKO when the FBPs no longer require access.

1.17.7 The USG TA will send a notice through the TASS to the AKO e-mail address provided IAW the above requirement. The FBPs user ID and password will be provided in the e-mail and will be require a change at first login. 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.

1.17.8 The FBP shall log into the TASS and complete the verification process by submitting the application back to the TA for approval.

1.17.9 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 individual’s e-mail address provided within 48 hours after submission. If the application is returned or rejected, the contract service provider shall contact the TA and comply with the TA’s guidance to attempt to correct and resolve the issues.

1.17.10 Upon approval of the application, the contract service provider shall receive an e-mail sent to the address provided stating the Common Access Card (CAC) application was approved and to proceed to the Verifying Office (VO) with two photo IDs to obtain a CAC. For CAC issuance, a DD2842 must be completed and taken by the individual with two forms of picture ID. The e-mail will contain a URL to download the form. Acceptable forms of ID to include: Driver’s License, Military ID, contractor Company ID with picture and expiration date, charge card with picture imprinted, and passport.

1.17.11 Revalidation Requirements. The TA is required to revalidate all contract service providers, in the DEERS/RAPIDS System, every 6 months. In the event revalidation is denied, the CAC credentials shall be revoked and the Card will not be useable to login.

1.17.12 Out-processing Requirements. When a contract service provider’s performance under this contract ceases, the contractor or FSO shall provide written notice to the TA. The TA will remove the contract service provider from the DEERS/RAPIDS System. The contractor shall ensure the contract service provider’s CAC is turned in to the Government IAW the out-processing procedures and further guidance from the KO.

1.17.13 The contractor is responsible for absences of their employees 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. The contractor shall immediately report any lost or stolen badges to the COR.

1.18 An Identification (ID) badge or Common Access Card (CAC) will not be issued until the provider has been fingerprinted and complete documentation has been submitted to the appropriate Security Manager(s), as required by the government. Upon award of the contract, the Contractor will immediately contact the COR for information needed to access the installations/MEPS initially. If a background investigation results in an unfavorable finding; or if an excessive amount of time (2 months) is taken to complete and submit required information or corrections to a background investigation application, the KO will notify the Contractor and the provider will not be granted access to the MEPS, will not be able to perform services at the MEPS, and must return all identification badges, CAC cards, and other items previously issued by the government.

a. In-processing Requirements. Contractor personnel are prohibited from performing services under this contract absent compliance with the in-processing requirements set forth below.

1. For every contract service provider, the FSO shall provide the following information to the TA for input into the https://www.dmdc.osd.mil/tass

DEERS/RAPIDS System:

(a) Last Name

(b) First Name

(c) Middle Name

(d) Social Security Number

(e) Date of Birth

(f) E-mail Address (may be either the e-mail address of the incoming individual or the FSO).

2. The contract service provider shall have an Army Knowledge Online (AKO) account in order to submit the application. AKO registration may be accessed via https://www.us.army.mil

3. The DEERS/RAPIDS Systems will send a notice to the e-mail address provided IAW the above requirement, in which the contract service provider’s user ID and password are provided. In the event the e-mail message is sent to the FSO, the FSO shall notify the contractor of the provider’s user ID and password.

4. The contract service provider shall log into the DEERS/RAPIDS System, and submit an application for acceptance into the System, using the user ID and password provided.

5. 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 individual’s e-mail address provided within 48 hours after submission. If the application is returned or rejected, the contract service provider shall contact the TA and comply with the TA’s guidance to attempt to correct and resolve the issues.

6. Upon approval of the application, the contract service provider shall receive an e-mail sent to the address provided stating the Common Access Card (CAC) application was approved and to proceed to the Verifying Office (VO) with two photo IDs to obtain a CAC. For CAC issuance, a DD2842 must be completed and taken by the individual with two forms of picture ID. The e-mail will contain a URL to download the form. Acceptable forms of ID are: Driver’s License, Military ID, Contractor Company ID with picture and expiration date, VISA charge card with picture imprinted, and passport.

b. Revalidation Requirements. The TA is required to revalidate all contract service providers, in the DEERS/RAPIDS System, every 6 months. In the event revalidation is denied, the CAC credentials shall be revoked and the Card will not be useable to login.

c. Out-processing Requirements. When a contract service provider’s performance under this contract ceases, the contractor or FSO shall provide written notice to the TA. The TA will remove the contract service provider from the DEERS/RAPIDS System. The contractor shall ensure the contract service provider’s CAC is turned in to the Government IAW the out-processing procedures and further guidance from the Center for Health Care Contracting.

During contract transition period, the contractor shall organize, plan, recruit personnel, train, mobilize, develop policies and procedures, and accomplish all administrative actions necessary to commence performance of the services at the start of the basic contract period.

1.18.1 When requested by the COR, FBPs shall complete and submit a DD Form 2875 (System Authorization Access Request) to the Contractor for inclusion in their initial credentials package in order to obtain access to USMEPCOM electronic applicant medical information and any other data. HQ USMEPCOM requires a new DD Form 2875 for every system that a FBP might access.

https://www.us.army.mil/

1.19 IDENTIFICATION OF PRIVACY ACT. This contract requires the development of a system of records in accordance with the Privacy Act of 1974.

1.20 Closures. During anticipated closure of the facility due to declared training, holidays, unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise, the provider will only be paid for the actual hours that were worked.

1.21 If required by the MEPS, the Contractor shall have sufficient qualified personnel available so that all services are provided in the event a provider scheduled to work becomes ill, resigns, or is otherwise unavailable to work.

The substitutes/replacements shall have at least the minimum qualifications required for the DPC Level requested.

1.22 TRANSITION/PHASE-IN PERIOD. To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the Contractor shall have key personnel available during the 2-month transition period to perform recruitment, hiring, credential processing, training and obtaining signed FBP contracts.

During the transition period, the Contractor shall become familiar with physical screening examination requirements in order to commence full performance of services on the contract start date. The Contractor shall tour a MEPS medical section chosen by the COR for the purpose of understanding USMEPCOM accession medical mission.

1.23 CONTRACT PHASE-OUT PERIOD. The phase out transition will occur at the end of the period of performance and will include the disposition of Government-furnished equipment used by contractor employees and providers and the efforts listed in the preceding subparagraphs. If the KO requires additional phase out efforts by the incumbent in transitioning a successor contractor, FAR Clause 52.237-3, Continuity of Service, may be invoked and associated costs will be negotiated in accordance with the terms of this clause at that time.

1.24 HEALTH AND IMMUNIZATION REQUIREMENTS. All FBPs performing health care services under this contract shall comply with the Health and Immunization requirements identified below at the time of initial application request to perform accession medical services at the MEPS. Health and immunization documents for new providers will be submitted with the initial credentials package. The contractor shall provide complete verification of updated health and immunization requirements every two years as specified for all Fee Basis Providers from the date the provider was initially qualified, 95% of providers shall meet the 2 year standard. Health and Immunization documents shall be submitted to the COR not later than five business days from when updates to these documents are received (see Exhibit D for Immunization Status Format):

1.24.1 Medical Evaluation. No FBP shall perform services under this contract unless a medical evaluation has been performed not more than sixty (60) calendar days prior to submission of credentials, 95% of FBPs shall have met this standard prior to submission of credential packages. The purpose of this medical evaluation is to determine if the individual, from a medical standpoint, possesses the minimum physical abilities needed to perform the proposed job without significant risk to personal health or the health and safety of others.

1.24.2 As a minimum, the individual shall be free of any medical conditions which might reasonably be expected to place other workers, patients, or the public at risk. Not later than five (5) days prior to the commencement of performance of services under this contract by any employee, the contractor shall provide certification to the COR that such employees have completed the medical evaluation requirements identified below. This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination, and a statement concerning the physical health of the individual.

1.24.2.1 The Contractor shall ensure all FBPs performing applicant physical examinations under this contract receive an occupational physical examination at the contractor’s expense prior to commencement of services. The contractor shall provide the COR an occupational physical examination certificate with the packages submitted for initial application and every two years thereafter for each FBP who will provide services. The certification shall state the date on which the physical examination was completed along with the name and signature of the physician who performed the examination. For the purposes of this paragraph an occupational physical examination primary purpose is to establish a baseline record heavily weighted on an individual reported state of health and includes a review of immunizations (paper record or laboratory). An occupational physical examination administered more than 6 months prior to the submission to USMEPCOM will not be considered adequate. Along with the baseline record of reported state of health, the physical examination shall include the following:

1.24.2.2 A history to show that the provider has completed a primary series of immunization with tetanus and diphtheria toxoids, a history of a one-time Tdap adult booster and that a booster dose (Td or Tdap) is current (within the past 10 years in accordance with CDC guidelines).

1.24.2.3 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) within 6 months of initiation and shall be tracked by the contractor and reported to the COR. A FBP may decline a Hepatitis B vaccination but must sign a declination letter on contractor letterhead which the contractor will submit to the COR not later than 10 days after FBP signs the declination letter. The letter must state the provider understands that due to his/her occupational exposure to blood or other potentially infectious materials the provider may be at risk of acquiring Hepatitis B virus (HBV) infection along with statement that “I decline Hepatitis B vaccination at this time.”, “I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease.”, and “If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with Hepatitis B vaccine, I will follow my employer’s policies for receiving the vaccination series.” See Exhibit G, Hepatitis B algorithm regarding documentation needed to meet this requirement. The documentation of Hepatitis B immunity is only required at initial application.

1.24.3 All contract FBPs shall receive an annual influenza immunization, unless there is a documented medical or religious reason not to be immunized. The contractor is responsible for ensuring its FBPs receive an influenza immunization as it will not be provided by the Government. The contractor shall provide evidence of annual immunizations or the physician’s declination statement to the COR. The influenza immunization shall become mandatory if a contract FBP becomes ill with influenza.

1.24.4 Contractor's FBPs shall be screened for tuberculosis by a tuberculin skin test using the Mantoux technique or TB blood tests (CDC standard). A skin test result of 10 mm of induration or more will require a chest roentgenogram and an evaluation performed. A tuberculin skin test of 10 mm of induration or more will require documentation providing an assessment of the patient (status of infection active, inactive; need for preventive treatment or not as determined by age) and the contractor shall furnish proof of treatment from the examining physician if requested. If FBP has a history of Bacillus Calmette Guerin (BCG) vaccination, TB blood tests are recommended as those tests are not affected by prior BCG. See Exhibit H, TB algorithm for required documentation. TB testing is only required for initial application.

1.24.5 If all of the immunizations and tests set forth in the preceding paragraphs have not been completed for the incumbent providers (providers already qualified by USMEPCOM prior to the beginning of this contract) the contractor shall provide a schedule not to exceed 6 months. The six (6) months shall start from the initiation of the new contract. 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.

1.24.6 All contract FBPs performing under this contract, who experience a parenteral (e.g., needle stick or cut) or mucous membrane exposure (e.g., splash to the eye or mouth) to blood or other body fluids, shall receive prompt treatment in accordance to the procedures detailed in USMEPCOM Regulation 40-9, Blood Borne Pathogen Program.

1.24.7 Unless there is a documented medical or religious reason not to be immunized, failure to meet the requirements stated herein, or when test results determine a FBP has a contagious disease, the Contracting Officer may, upon the advice of the Command Surgeon or his/her designee, determine that such FBP is not an acceptable individual to perform services under this contract.

1.24.8 If, in the opinion of the evaluating medical practitioner, the individual is found to be qualified for duty, the medical statement shall include the following wording: “(NAME OF EMPLOYEE) possesses the minimum physical abilities to perform the proposed duties of a Fee Basis Provider. He/she has documented proof of immunization against/immunity to rubella, and Hepatitis B and does not have an active infectious condition which might place others at risk.” If, in the opinion of the evaluating medical physician, the individual does not possess the minimum capabilities needed to perform the proposed job or does not meet the conditions of employment or will pose a risk to others, the medical statement shall contain the following wording: “For medical reasons, (NAME OF EMPLOYEE) is not qualified for a position as a FBP.” Certification shall be provided to the KO and COR.

1.24.9 Removal of Providers. At any time during the performance of this contract, the KO or COR may direct the Contractor to remove any provider whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to an applicant, other providers, and government personnel or to the impaired individual. This provision will be used in emergencies only and not for bringing performance issues or other non-urgent concerns to the attention of the Contractor.

1.24.10 If the need for a removal occurs, the COR will contact the Contractor 's point of contact and direct the Contractor to remove that individual from the MEPS and to not use that individual to perform any services required under this contract until the issue has been resolved by the KO. A review of the basis for removal will be made by the KO within 3 working days after the COR directed the removal.

1.24.11 If, after any investigation deemed necessary by the KO and discussions with the Contractor’s representative, the KO concludes that the provider's impairment requires permanent removal from performance under the contract, the KO will notify the Contractor that permanent removal is required. In the event of disagreements between the government and the Contractor’s representative concerning matters of impaired providers, the decision of the KO will be final. During the period between the removal and the final decision of the KO, the Contractor shall agree to provide a backup/replacement provider IAW the terms and conditions of this contract.

1.25 RUBBER STAMP. The Contractor shall ensure FBPs providing accession medical services under this contract have a rubber stamp containing their full name, degree, title, and company name. The stamp shall be placed on all forms and documentation having the FBP’s signature. The stamp should only be one line due to space limitations on the applicant’s medical record.

EXAMPLE:

Jane J. Jones, MD, FBP

2. DEFINITIONS AND ACRONYMS:

2.1 DEFINITIONS

2.1.1 ACCESSION MEDICINE. A phrase coined by J-7/MEMD to epitomize the activities of USMEPCOM centered on evaluating the suitability of the moral, physical and mental condition of prospective applicants for entry in to military service. Accession medicine is unique to the USMEPCOM medical departments for performing accession medical services. USMEPCOM accession medicine physicians ensure accession standards as defined in the Department of Defense Instruction (DODI) 6130.03 are applied appropriately for each applicant.

2.1.2 ACCESSION MEDICAL SERVICES. USMEPCOM medical services provided during the medical examination processing of applicants for the Armed Services. Medical services include but are not limited to prescreen reviews of applicant medical history, medical history interviews, physical screening examinations, reviews of medical test results, determinations of whether an applicant does or does not meet accession medical standards, physical inspections, and overseeing MEPS medical department regulatory compliance.

2.1.3 ASSISTANT CHIEF MEDICAL OFFICER (ACMO). Government service physician located at larger MEPS in the medical department. The ACMO uses their professional training and judgment to apply medical qualification standards set forth by the Department of Defense policy. ACMOs are approved to perform accession medical services in a MEPS by the USMEPCOM Command Surgeon/ J-7/Medical Director (or designated representative) and medical determinations of ACMOs are subject to review by HQ USMEPCOM physicians.

2.1.4 CHIEF MEDICAL OFFICER (CMO). Government service physician responsible for medical operations at each MEPS or processing facility. The CMO uses their professional training and judgment to apply medical qualification standards set forth by the Department of Defense policy. The CMO is supervised by the MEPS Commander who has complete authority, within the rules and regulation of the USMEPCOM, to direct the CMO regarding administrative matters. CMOs are approved to perform accession medical services in a MEPS or processing facility by the USMEPCOM Command Surgeon J-7/Medical Director (or designated representative) and medical determinations of CMOs are subject to review by HQ USMEPCOM physicians.

2.1.5 CONTRACTOR. The term as used in this contract refers to the prime.

2.1.6 CONTRACTING OFFICER (KO). A person with authority to enter into contracts; administer, or terminate contracts. Make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.7 CONTRACTING OFFICER’S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to monitor contractor performance. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.8 Defined Provider Category (DPC). DPC levels are a sequential process whereby providers are assigned performance levels based on provider experience knowledge and ability. There are four DPC levels of assignment which are granted for contract providers. Levels range from DPC-1 through DPC-4.

2.1.8.1 DPC-1

a. Applies to new providers working under the direct supervision of a government physician during initial accession medical training. A provider must be approved for DPC-1 prior to working at a MEPS. Approval for DPC-1 is based on a J-7/MEMD review of a providers professional credentials.

b. When working in a DPC-1 status, the provider’s performance will be under close review by his/her clinical supervisor for clinical competence as well as for compliance with the MEPS policies and procedures.

c. Once the DPC-1 training and evaluation is completed, requests for assignment to DPC 2 shall be submitted to J- 7/MEMD as described in Chapter 4.

2.1.8.2 DPC-2

a. Providers completing DPC-1 training are qualified for DPC-2. Supervising government physicians will seek approval from the J-7/MEMD for progression from DPC-1 to DPC-2 by submitting a request to J-7/MEMD.

Providers designated as DPC-2 may include physicians, certified nurse practitioners, and physician assistants who are capable of performing medical history interviews and accession physical examinations without supervision.

DPC-2 providers are not qualified to assess medical accession standards in order to assign applicant profiles, and they cannot serve as a Fee Basis CMO (FB-CMO) under this contract.

b. Certified nurse practitioners and physician assistants cannot independently assign applicant profiles so they can only qualify for DPC-1 or DPC-2. DPC-2 Physicians are qualified to proceed with training to sequentially obtain DPC-3 and DPC-4 levels.

c. For physicians, DPC-2 is normally a temporary assignment of six months or less in which the provider, newly trained in accession medicine, gains proficiency in performing accession medicine physical examinations, and learns the elements of accession medical standards.

d. Once the DPC-2 training and evaluation is completed, requests for assignment to DPC 3-4 shall be submitted to J-7/MEMD per Chapter 4.

2.1.8.3 DPC-3

a. Physicians designated as DPC-3 are qualified to profile applicants by applying accession medical standards to determine applicant medical qualifications. DPC-3 does not include supervisory responsibilities associated with CMO, ACMO, and FB-CMO roles.

b. FBP physicians are expected to become proficient in the application of accession medical standards to determine suitability of applicants for military service, and progress from DPC-2 to DPC-3 during their initial six month period of employment with a minimum of 80 hours of FBP service. FBP’s who are unable to assimilate and master profiling abilities and remain at DPC-2 for more than six months will be evaluated by the MEPS CMO and receive a performance evaluation advising either retraining or other continued employment recommendations in order to meet the terms of this contract. MEPS will submit documentation to the COR for all performance issues.

2.1.8.4 DPC-4

a. The supervising government physician may recommend advancement of a DPC-3 FBP to DPC-4 status by submitting a request to J-7/MEMD, asking approval from the PQMP for progression from DPC-3 to DPC-4. Under the FBP contract, DPC-4 FBPs can be scheduled as FB-CMOs. During vacancies or absences of the CMO, and the ACMO, as applicable, a FB-CMO provides medical expertise to the MEPS as the on-site clinical expert.

b. DPC-4 duties include compiling medical histories, conducting physical screening examinations, reviewing medical test results, documents, and consultations, and serving as the subject matter expert for medical questions, including providing technical advice and guidance to the MEPS Commander and all medical staff to achieve the ultimate level of quality and service in processing applicants for military service. DPC-4 physicians will consult with J-7/MEMD physicians for assistance with applicant processing when regulatory guidance does not provide clear solutions.

2.1.9 FEE BASIS CHIEF MEDICAL OFFICER (FB-CMO). A FBP (contract employee) who is assigned for a specified work day as the temporary CMO when the CMO is absent and the MEPS does not have an ACMO available. A FB-CMO must be a physician assigned and approved by USMEPCOM for DPC-4. FB-CMO will accomplish medical histories; physical medical examinations; reviews of required medical tests and documents pertaining to consultations and medical histories; assessments of applicant medical documentation and render their medical opinion on an applicant’s medical qualification for serving in the Armed Forces. FB-CMOs apply set DOD medical standards when determining medical qualifications. When medical standards are unclear or ambiguous regarding the medical qualifications of an applicant the FB-CMO will consult with a HQ USMEPCOM physician.

When performing as the FB-CMO, the FBP shall attend the local inter-service recruiting council meeting as required to discuss MEPS specific medical issues when requested by the MEPS Commander

2.1.10 FEE BASIS PROVIDER (FBP). Medical Doctor (MD) or (Doctor of Osteopathy (DO), Physician Assistant (PA), or Certified Nurse Practitioner (CNP), all of which are contract employees, who conduct enlistment physical medical examination screenings at a MEPS.

2.1.11 MEDICAL EXAMINATION (FULL). A full medical examination which includes profiling and contains all required basic elements, including the evaluation of consultation and/or medical letters.

2.1.12 MEDICAL COMMUNICATIONS. Integrates, fields and supports a comprehensive medical information system, enabling lifelong electronic medical records.

2.1.13 MEDICAL EXAMINATION (“INSPECT”). Reassessment of an applicant’s recent medical history and current physical condition, if more than 72 hours have elapsed since last MEPS medical evaluation when entering active duty or more than 30 days to enter the delayed entry program.

2.1.14 MEDICAL MISSION FAILURE. A term that describes the situation where a MEPS orders a fee basis provider and the vendor does not fill this order.

2.1.15 MEDICAL NON-COMMISSIONED OFFICER IN CHARGE (NCOIC)/ SUPERVISORY MEDICAL

TECHNICIAN (SMT). Individual (Government employee) responsible for the administrative operation of the MEPS medical department.

2.1.16 MILITARY ENTRANCE PROCESSING STATION (MEPS). DOD activity responsible for administering aptitude tests, medical examinations and administrative processing of Armed Forces applicants.

2.1.17 MILITARY TIME is on a 24 hour clock, i.e.:

8:00 am – 0800 9:10 am – 0910 Noon – 1200 8:00 pm – 2000 9:10 pm – 2110 Midnight – 2400 12:01 am – 0001

2.1.18 MILITARY DATES are written by placing the four digits of the year, followed by the two digits of the month, followed by the two digits of the day, i.e.:

September 2, 2008 – 20080902 September 10, 2008 – 20080910

2.1.19 NON-PROFILER. FBP who does not sign for physicals. Non-profilers do not hold as much responsibility as Profiler’s and are assigned to DPC-1 and DPC-2 levels only

2.1.20 PERSONAL SERVICES CONTRACT. A personal services contract is defined in the Federal Acquisition Regulation (FAR), Subpart 37.104, Personal Services Contracts, as a contract that is characterized by the employer-employee relationship it creates between the Government and the contractor’s personnel. FBPs providing services under this contract will render personal services to the Government and are subject to the relatively continuous supervision and control of a Government officer or employee. Supervision and control is the process by which the individual FBPs receive technical guidance, direction, and approval with regard to a task(s) within the requirements of this contract. All other employer/employee duties and responsibilities (payroll, etc.) remain the responsibility of the prime contractor. Personal services contracts are entered into under the authority of Section Title 10, Section 1091, United States Code (USC), Personal Services Contracts.

2.1.21 PHYSICAL SECURITY. Actions that prevent the loss or damage of government property.

2.1.22 PROFILER. Government physician or FBP physician who are approved to profile and are assigned to at least DPC-3 per USMEPCOM Regulation 40-2. FBP must work at the MEPS or processing facility for at least 80 hours and receive a recommendation from a MEPS CMO in order to be considered for profiling (DPC-3). The 80-hour requirement shall be completed in addition to the 40-hour initial training requirement under DPC-1, unless an exception to policy is requested by the CMO and approved by J-7. FBP will accomplish medical histories; physical examinations; reviews of required medical tests and documents pertaining to consultations and medical histories;

assessments of applicant medical documentation to render a medical opinion on an applicant’s medical qualification for serving in the Armed Forces. This will be accomplished by using qualification standards set forth by Department of Defense policy under the general supervision of the MEPS CMO or designated representative.

2.1.23 FBP NON-PROFILER PHYSICIAN: FBP physician that does not have profiling assigned and cannot render a medical opinion on an applicant’s medical qualification for serving in the Armed Forces. FBP will accomplish medical histories; physical examinations; reviews of required medical tests and documents pertaining to consultations and medical histories.

2.1.24 FBP NON-PROFILER NON-PHYSICIAN: FBP Physician Assistant or Certified Nurse Practitioner that does not have profiling responsibilities and cannot render a medical opinion on an applicant’s medical qualification for serving in the Armed Forces. FBP will accomplish medical histories; physical examinations; reviews of required medical tests and documents pertaining to consultations and medical histories and not progress beyond DPC-2.

2.1.25 PROFILING. A system for classifying individuals according to functional abilities. It is based primarily upon the function of body systems and their relation to military duties. It is applicable for physical exams for enlistment, appointment or induction, and is used to specify whether an applicant meets the relevant physical standards or not.

2.1.26 PROVIDER QUALITY MANAGEMENT PROGRAM (PQMP). USMEPCOM program which provides technical management and quality oversight of the medical provider pool. The PQMP includes prior to hire, an initial professional review; training of medical providers in the specialized area of accession medicine; and maintenance of quality performance.

2.1.27 INITIAL PROFESSIONAL REVIEW PROGRAM. The Initial Professional Review Program provides the qualification process resulting in a provider being granted tiered permissions and responsibilities to provide accession medical services designated by DPC levels. Qualification includes official review and acceptance of an individual’s professional credentials as certified by a national agency or association deemed acceptable to USMEPCOM in order to assure the public that the medical professional has successfully completed an approved educational program and is professionally licensed to practice medicine in at least one state. Providers qualified as DPC-1 (entry level) are eligible acceptable to work under the FBP contract for their employer once the provider signs a personal services contract associated with the FBP contract.

2.1.28 INITIAL TRAINING PROGRAM. The Initial Training Program provides standardized training for new CMOs, ACMOs and FBPs in order to educate the new provider in accession medical services. Clinical Operations Division physicians will document training requirements in a PQMP Training Standard Operation Procedure (SOP) located on the USMEPCOM intranet which includes but is not limited to training on policies in DOD Instruction (DODI) 6130.03, Medical Standards for Appointment, Enlistment, or Induction in the Military Services;

USMEPCOM Regulation 40-1, Medical Processing and Examinations; USMEPCOM Regulation 40-8, Department of Defense (DOD) Human Immunodeficiency Virus (HIV) Testing Program and Drug and Alcohol Testing (DAT) Program; and USMEPCOM Regulation 40-9, Blood borne Pathogen Program.

2.1.29 QUALITY PERFORMANCE MAINTENANCE PROGRAM. The Quality Performance Maintenance Program provides recurring reviews, assessments, feedback, and sustainment training to ensure a quality medical program and continued quality performance of the USMEPCOM medical provider pool.

2.1.30 QUALITY ASSURANCE (QA). The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.31 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). Identifies the metrics to measure success of the overall contract performance.

2.1.32 QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.33 SUBCONTRACTOR. One that enters into a subcontract and assumes some of the obligations of the primary Contractor.

2.1.34 TECHNICAL REPRESENTATIVE. An individual from the MEPS medical department, normally the Medical Department NCOIC/Supervisory Medical Technician, who will provide technical expertise to the COR as required.

2.1.35 TRAVELING PROVIDER. If the Contractor has a MEPS or processing facility requirement for a FBP and there is not one…