W90VN6-17-T-0010-0001.pdf

411TH CSB, KOREA - RCO OSAN

POC: MR. HWANG, PYONG HA

TEL: 011-82-31-661-9190

PYONGHA.HWANG.LN@MAIL.MIL

APO AP 96278-2039

UNITED STATES OF AMERICA (THE)

F3J4MD6258AQ01

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to revise the Performance Work Statement (PWS) for a better understanding of contractor responsibility.

The revised paragraphs are highlighted in yellow (Para. 3.7.3.1 & 3.7.3.4).

1. CONTRACT ID CODE PAGE OF PAGES

J 1 23

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

16C. DATE SIGNED

BY 12-Jan-2017

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W90VN6-17-T-0010

X 9B. DATED (SEE ITEM 11)

30-Dec-2016

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

12-Jan-2017

CODE

411TH CONTRACTING SUPPORT BRIGADE, KOREA

RCO OSAN, UNIT #2039

APO AP 96278-2039

UNITED STATES OF AMERICA (THE)

W90VN6 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE W90VN6

FACILITY CODECODE

EMAIL:TEL:

W90VN6-17-T-0010

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

The following have been modified:

PWS

PERFORMANCE WORK STATEMENT

FOR NETWORK ACCESS CLERK

OSAN AIR BASE, KOREA

TABLE OF CONTENTS

SECTION TITLE

1.0 INTRODUCTION

2.0 BACKGROUND

3.0 SCOPE OF WORK

4.0 QUALITY ASSURANCE SURVEILLANCE PLAN

5.0 POSITION DESCRIPTIONS

6.0 APPLICABLE TECHNICAL ORDERS, SPECS, REGULATIONS, AND MANUALS

7.0 ACRONYMS AND DEFINITIONS

1.0. INTRODUCTION.

1.1. The contractor shall provide the non-personal services of _NETWORK ACCESS CLERK_ 51st MEDICAL GROUP, OSAN AIR BASE, KOREA also referred to as the “Medical Treatment Facility” (MTF). The Contractor shall provide administrative service and support to TRICARE Operations and Patient Administration (TOPA) Referral Management Center (RMC). The RMC provides referral authorization processing and appointment booking for beneficiaries of Osan AB and surrounding beneficiaries. The RMC provides consistent information, reducing beneficiary confusion and dissatisfaction in the appointment referral process, and provides the means for providers and staff to check the present status of referrals in the Composite Health Computer System (CHCS). The RMC utilizes the CHCS Managed Care Program (MCP) and Booked Healthcare Finder (BHCF) module to book and manage referral appointments. The RMC tracks referrals from the beginning to the conclusion of treatment to ensure TRICARE MCP access standards are met for both external and internal 51st Medical Group referrals.

Provides documentation of appointments and referrals and ensures each is appropriately processed, distributed and documented in all of the CHCS modules. The RMC utilizes the Referral Management System (RMS) to coordinate authorization and referral appointing with the Managed Care Support Contractor (MCSC) and to accurately track and review referrals from start to finish. This enhances the flow of patients and associated paperwork, thus helping increase productivity of our providers and access to care for patients. Performance shall be in accordance with the requirements contained in this performance-based work statement (PWS).

1.2. All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, The Joint Commission (TJC) standards, the Accreditation Association for Ambulatory Health Care (AAAHC), American Heart Association (AHA), Military Training Network (MTN), applicable Department of Defense (DoD) and Air Force specific regulations, directives and policies as well as MTF specific regulations, policies and directives. These documents are available in the MTF and maintained by the Government. Supplements or amendments to instructions or publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes. The Contractor shall provide services for Network Access Clerk in accordance with established policies of the RMC.

The Contractor shall be held accountable for compliance to the standards listed in the Comprehensive Accreditation

Manual for Hospitals (CAMH), the Health Services Inspection (HSI) Guide, applicable Air Force Instructions (AFIs), current editions.

1.3. The contractor or contract personnel shall provide services in conjunction with other non-contract providers to include physicians, nurse practitioners, physician assistants, registered and licensed practical nurses, and support personnel. All contract personnel shall perform essentially the same functions, within the scope of acceptable practice for the specific specialty or position, as those required by Air Force or Government service health care professionals of similar experience and in similar duty assignments. The scope of services provided in military treatment facilities cover the same range of services as those that are provided in civilian treatment facilities of similar size and scope of services.

1. 4. This is a non-personal services contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailed in relationships between the government and its employees.

1.5. Period of Performance: The period of performance shall be for one (1) Base Year of 12 months and four (4) 12-month option years. The Period of Performance reads as follows:

Base Year: 1 April 2017 – 31 March 2018 Option Year I: 1 April 2018 – 31 March 2019 Option Year II: 1 April 2019 – 31 March 2020 Option Year III: 1 April 2020 – 31 March 2021 Option Year IV: 1 April 2021 – 31 March 2022

2.0. BACKGROUND.

2.1. The mission of the military healthcare system (MHS) is to ensure the nation has available at all times a healthy military force supported by a combat ready healthcare system. Health care services for eligible MHS beneficiaries are provided at MTFs located on or near military installations or posts. The MTF may be a clinic, hospital, or medical center. Clinics are outpatient facilities offering primary care and possibly, simple specialty care (routine exams, tests, treatments). The clinic may be a stand-alone site or a satellite of a larger clinic, hospital, or medical center.

2.2. The 51st Medical Group’s mission is to maximize the human weapon system, execute contingency operations, and deliver trustworthy care. The RMC, TOPA Flight, 51st Medical Support Squadron, 51st Medical Group, Osan AB, Republic of Korea, is responsible for managing the referral process from beginning to end from the time the provider submits the referral for specialty care. The RMC books all referral appointments, both internal and external, and provides customer service to patients on the referral process, as well as any and all paperwork required for referral care.

3.0. SCOPE OF WORK.

3.1. The contract personnel shall provide administrative and instructional service and support to the RMC, TOPA Flight. The contractor shall be primarily responsible for managing referral processing and appointing, ensuring access to care and following all applicable guidelines.

3.1.1. The Contract Personnel should take an orientation what the main specific duty and major tasks from Contract Company not government. Government has authorization to receive the right service on this PWS. Contract Company has obligation to provide right service on PWS 5.1.3. Specific Duties/Tasks.

3.2. Administrative.

3.2.1. Contractor Representative. The Contractor shall designate, in writing, a primary point of contact for contract coordination and implementation not later than five business days after receiving notice of contract award. Changes in the primary point of contact (POC), at any time, shall require the Contractor to notify the Contracting Officer

(KO) of the new representative at least five working days prior to the change. This notification shall be in writing and shall state the name and contact information for the new point of contact.

3.2.2. The Contracting Officer’s Representative (COR) will be the KO’s authorized representative in administering the contract at the MTF level. The Contractor’s representative shall be available to discuss any problems that the Contractor’s personnel may be experiencing during the performance of this contract. Problems experienced by the Government with the Contractor’s performance will be discussed and resolved. Unresolved problems will be referred to the KO for resolution.

3.2.3. The Contractor may use non-compete provisions in its employment agreements to prevent the loss of personnel by the Contractor during the period of performance of this contract. However, the Contractor shall not use non-compete provisions in its employment agreements that would prevent its contract personnel from being employed by or from accepting offers of employment from the new Contractor of the follow-on contract. It would hinder the Government’s ability to accomplish the mission of providing medical care to its beneficiaries.

3.2.4. The Contractor and contract personnel shall abide by all MTF standards, rules, and procedures including requirements for any licensure, credentialing and quality assurance requirements. Such regulations include, but are not limited to, general safety, fire prevention, waste disposal, infection control, The Joint Commission (TJC), and patient safety initiatives.

3.2.5. Media and Other Inquiries. The Contractor shall not respond to any media inquiries. Any inquiries from the media, third parties, or public agencies shall be immediately relayed to the COR, who will relay them to the MTF Public Affairs Officer or, after duty hours, to the Administrative Officer of the Day (AOD). There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the COR.

3.2.6. Emergency health care for contract personnel. The MTF will provide emergency healthcare for injuries or life threatening medical emergencies occurring while on duty at the MTF. The Contractor shall reimburse the Government for such services as billed by the MTF.

3.3. Conflict of Interest.

3.3.1. The Contractor or contract personnel shall not bill the patient for services rendered under this contract. The Contractor or contract personnel shall not request or accept compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified.

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

3.3.3. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of healthcare services under this contract. The Contractor shall not release any of the above information without prior written consent of the KO. The Contractor/contract personnel shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication. The contract personnel shall prepare medical records, forms and documents as required, in accordance with the regulations and established guidelines listed in the contract. See the Appendix A

3.3.4. The Contractor shall not employ active duty military or Government civilian employees to perform services under this contract.

3.3.5. The contract personnel shall not use Government facilities, supplies, or equipment in private practice or for any purpose other than providing the healthcare services required under this contract.

3.4. Security.

3.4.1. Security Identification Badges. The Contractor and contract personnel shall comply with the local installation and MTF personnel identification and access requirements while on site.

3.4.1.1. While on site, each contract personnel shall wear a visible security badge identification, provided by the military installation or the MTF, on the front of his/her outer clothing. The badge must show the full name, title and if required by the Military the word “Contractor” in front. The COR will provide the paperwork to request identification badges.

3.4.1.2. The Contractor is responsible for absences of contract personnel due to expired identification and access documents. Such absences shall not relieve the Contractor of its obligation to perform the healthcare services required under this contract.

3.4.1.3. The contract personnel shall immediately report any lost or stolen badges to the COR.

3.4.1.4. The contract personnel shall turn in all identification badges to the COR, or his/her designated representative upon termination of their services under this contract.

3.4.2. Vehicle Registration. The MTFs are located on restricted access military installations. The Contractor/contract personnel shall comply with the local installation requirements for vehicle registration and operation on the military installation. All contract personnel must register their vehicles with the office responsible for vehicle registration to gain access onto the military installation. A valid driver’s license, Government-furnished civilian identification, proof of insurance and current registration must be presented to the Provost Marshal’s Office, at which time a DoD decal will be issued. The decal shall be placed on the vehicle’s front windshield in accordance with instructions.

3.4.2.1. All vehicles, with or without a DoD decal, are subject to search. Contract personnel may encounter long delays for vehicle inspection and identification checks upon entering and exiting the installation. The Government will not reimburse the Contractor for time spent at installation checkpoints. Contract personnel must plan accordingly and report to work at their scheduled duty time, at their appointed place of duty within the MTF.

3.4.2.2. Contract personnel shall follow installation procedures for removal and turn-in of the vehicle decal upon termination of services under this contract.

3.4.3. Keys. The Contractor shall be responsible for any keys issued by the Government to contract personnel for use in the MTF. The keys shall not be duplicated. The Contractor shall be financially responsible for the replacement of any lost keys and any associated locks. Lost keys and/or locks shall be reported to the issuing party, Flight Commander, or COR immediately upon recognition of the loss.

3.4.4. Safeguarding Material. The contract personnel shall be responsible for safeguarding all Government property. The Contractor shall safeguard information of a confidential or sensitive nature. All patient related information is considered confidential and sensitive. If working remotely, Contractors are prohibited from reproducing patient information in any way. This includes printing. Neither the Contractor nor any of its contract personnel shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the possibility of a breach in security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974. However, the Contractor may be required to provide testimony or disposition in cases of due process action.

3.4.5. Antiterrorism (AT) and Operations Security (OPSEC)

3.4.5.1. AT Level I Training: This provision/contract text is for contractor employees with an area of performance within an Army controlled installation, facility, or area. All contractor employees, to include subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete AT Level I awareness training within 50 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 KO, if a COR is not assigned within 20 calendar days after completion of training by all employees and subcontractor personnel.

3.4.5.2. Access and General Protection/Security Policy and Procedures: This standard language text is for contractor employees with an area of performance within an Army controlled installation, facility, or area. The contractor and all associated sub-contractors’ employees shall comply with applicable installation, facility, and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshall Office, Director of Emergency Services, or Security Office. The contractor workforce must comply with all personal identity verification requirements 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.

3.4.5.3. AT Awareness Training for Contractor Personnel Traveling Overseas: This standard language text required US based contractor employees and associated sub-contractor employees to make available and to receive government provided area of responsibility (AOR) specific AT awareness training as directed by AR 525-13.

Specific AOR training content is directed by the combatant commander with the unit Anti-Terrorism Officer (ATO) being the local point of contact.

3.4.5.4. iWATCH Training: This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 50 calendar days of contract award and within 50 calendar days of new employees commencing performance with the results reported to the COR NLT 60 calendar days after contract award.

3.4.5.5. For Contracts that Require an OPSEC Standing Operating Procedure (SOP)/Plan: The contractor shall develop an OPSEC SOP/Plan within 90 calendar days of contract award, to be reviewed and approved by the responsible Government OPSEC officer, per AR 530-1, Operations Security. This SOP/Plan will include the government's critical information, why it needs to be protected, where it is located, who is responsible for it, and how to protect it. In addition, the contractor shall identify an individual who will be an OPSEC Coordinator. The contractor shall ensure this individual becomes OPSEC Level II certified per AR 530-1.

3.4.5.6. For Contracts that Require OPSEC Training: Per AR 530-1, Operations Security, new contractor employees must complete Level I OPSEC training within 30 calendar days of their reporting for duty. All contractor employees must complete annual OPSEC awareness training.

3.4.5.7. For Contractors Requiring Performance or Delivery in a Foreign Country, DFARS Clause 252.225-7043, Antiterrorism/Force Protection for Defense Contractors Outside the US: The clause shall be used in solicitations and contracts that require performance or delivery in a foreign country. This clause applies to both contingencies and non-contingency support. The key AT requirement is for non-local national contractor personnel to comply with theater clearance requirements and allows the combatant commander to exercise oversight to ensure the contractor’s compliance with combatant commander and subordinate task force commander policies and directives

3.5. ORIENTATION AND TRAINING.

3.5.1. MTF in-processing checklist. When commencing work under this contract, the contract personnel shall obtain in-processing checklist(s) from the COR or designated office(s). All contract personnel are required to complete the applicable items on the checklist(s) and turn it in to the designated office(s). Upon completion of the duty assignment, the contract personnel need to complete an out-processing checklist(s) and return it to the designated office(s). The Contractor shall ensure that all contract personnel participate in the MTF orientation procedures for newly assigned employees to include regulations specific to their professional specialty and hospital and Air Force policy and procedures.

3.5.2. MTF and Unit Orientation. The contract personnel shall be provided with a Government paid orientation to familiarize the contract personnel with the policies and procedures of the MTF, assigned department and specific unit. Orientation shall be completed within 30 days.

3.5.3. Annual training requirements. The Contractor shall ensure that contract personnel complete any mandatory annual training requirements in accordance with national accreditation agencies and 51st Medical Group policies.

3.5.4. Government unique training. The Government may elect to provide unique Government training to contract personnel 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 contract personnel.

When directed by the KO, contract personnel 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 contract personnel fails to satisfy the performance commitment after the contract personnel 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 contract personnel 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.

3.5.5. Computer Training. Contract personnel who have any interaction with the MTF computer systems must receive training for the applicable system(s). The COR will coordinate the necessary computer training. The training will be on-site and during normal duty hours. This training will be at no cost to the Contractor.

3.5.6. The Contractor must receive training CHCS, AHLTA and HAIMS systems.

3.5.7. The Contractor must receive training Basic Life Support Cardiopulmonary Resuscitation / Automated External Defibrillator (BLS CPR/AED) certification every year. The Medical Group will provide this training.

3.6. MTF HOURS OF OPERATION

3.6.1. The MTF provide services 24 hours a day, 365 days a year (366 days during leap years) including holiday.

Clinics have designated operating hours.

3.6.1.1. TOPA Hours of Operation: The contract personnel shall be available to work 0800 to 1700, Monday through Friday, with a one-hour lunch break for an 8-hour work day.

3.6.2. Holidays. The following is a list of legal federal holidays. Any of the federal holidays falling on a Saturday will be observed on the preceding Friday. Holidays falling on a Sunday will be observed on the following Monday.

Contract personnel may be required to work on legal holidays as determined by the COR.

New Year’s Day, January 1st Martin Luther King’s Birthday, 3rd Monday in January President’s Day, 3rd Monday in February Memorial Day, Last Monday in May Independence Day, July 4th Labor Day, 1st Monday in September Columbus Day, 2nd Monday in October Veteran’s Day, November 11th Thanksgiving Day, 4th Thursday in November

Christmas Day, December 25th

NOTE 1: 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 personnel 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. The contractor will also not have to provide services on Pacific Air Forces Command (PACAF)’s family days or 51st Fighter Wing down days.

3.6.3. Contract personnel shall report to work as scheduled during emergencies, disasters or during adverse weather conditions. Contract services are still required during these situations.

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

3.7. HOURS OF PERFORMANCE.

3.7.1. Scheduling process: The contract personnel shall be available to work 0800 to 1700, Monday through Friday, 8-hour workdays with a one-hour lunch. The contract personnel may be required to report to work on a non-standard workday. This is unique and will be scheduled in advance.

3.7.1.1. The contractor cannot exceed 40 hours per week and cannot receive compensatory time-off equal to the overtime worked.

3.7.1.2. The Network Access Clerk shall not leave a tour of duty early without the approval of the Flight Commander/Flight Chief.

3.7.2. Scheduling issues sample:

The COR or their designee will be responsible for communicating with the contractor regarding scheduling issues.

3.7.3. Absences and leave:

3.7.3.1. Contractor personnel will be allowed 160 hours of absences per year for vacation, sick leave and miscellaneous reasons. The absences are to be coordinated with, and at the discretion of, COR or appointed a Functional Requirements Evaluator Designees (FRED). The Contractor shall notify the COR when a scheduled contract personnel cannot fill a shift due to illness or emergency. Notification shall be as early as possible, but no later than 2 hours prior to start of scheduled shift.

3.7.3.2. The contractor shall have sufficient qualified personnel available so that all services are provided in the event a contract personnel scheduled to work becomes ill, resigns, is terminated or otherwise unavailable to work.

The proposed substitutes shall have at least the minimum qualifications required for the position.

3.7.3.3. When the contractor cannot fill a position, the contractor shall notify the COR.

3.7.3.4. Continuity of Services/Replacement Staff. The Contractor point of contact shall ensure qualified personnel are available to provide coverage during scheduled absences of primary contract provides or when they will be unable to provide services for three (3) or more scheduled duty day.

3.7.4. Scheduled absences of contract personnel shall be coordinated with the COR at least 30 calendar days in advance. Absences will not excuse the performance of any duty under this contract.

3.7.5. The Contractor is responsible for submitting an accurate invoice.

3.8. Health and immunization requirements. All contract personnel performing services under this contract shall comply with the health and immunization requirements as stated in the Health Requirements clause.

Backup/replacement contract personnel shall meet the same health and immunization requirements. The expense to comply with the health and immunization requirements shall be borne by the Contractor at no additional cost to the Government.

3.9. Criminal History Background Check Requirements. Contract personnel determined by the MTF to be involved in the delivery of health care to children under the age of 18 on a frequent and regular basis must meet the requirements of the Crime Prevention Act of 1990, as specified in the Criminal History Background Check Requirements clause.

3.10. Contractor Verification System (CVS).

3.10.1. The Contractor shall comply with agency personal identity verification procedures identified in the contract 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.

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

3.10.3. 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), and the Contractor shall designate a Facility Security Officer (FSO), for this contract. The Government reserves the right to amend or supplement these provisions pursuant to the Changes clause in the contract.

3.11. QUALITY MANAGEMENT

3.11.1 The Contractor shall have a planned and systematic quality management process for monitoring and analyzing its contract performance.

3.11.2. The contract personnel shall comply with the MTF quality management/process improvement activities.

4.0 QUALITY ASSURANCE SURVEILLANCE PLAN: See Attachment 1.

4.1. Inspection. The inspection and acceptance point for all services rendered under this contract will be the COR.

The performance by the contract personnel, the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance and review for acceptance by the KO or COR. Any services rendered by the contract personnel to patients or interaction with military/civilian personnel deemed unprofessional, threatening, or dangerous by the KO will be grounds for immediate termination for default or cause. Quality Assurance procedures established by the MTF shall be used for continuous monitoring.

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; customer service comments; Contractor relationship with hospital staff/Government contracting personnel; compliance with hospital policies and procedures.

4.2. Medical Quality Assurance/Risk Management (QA/RM) Orientation. The Contractor shall ensure that the contract life support training coordinator participates in the MTF orientation procedures for newly assigned contractors to include regulations specific to their professional specialty and hospital and Air Force policy and procedures.

4.3. Performance Requirements Summary: The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

PERFORMANCE REQUIREMENTS SUMMARY

Performance Objective Performance Standard Performance Threshold

Contract Reference Method of Surveillance/Frequency

Orientation

Company provides proper Education to require for work Compliance 100%

100% PWS Para 3.1.1.

Periodic Surveillance/ Customer complaints

Training

Contractor complete the support training Compliance 100% during the life of the ontract.

100% PWS Para 3.5.

Periodic Surveillance/ Customer complaints

Network primary care referral

Contractor reviews initial specialty care and deferred to network primary care referrals for administrative completeness

100% PWS Para 5.1.3.1.1.

Periodic Surveillance/ Customer complaints

Patient Scheduling

Calls patients as need to schedule, reschedule, and/or cancel appointments.

100% PWS Para 5.4.4 Periodic Surveillance/ Customer complaints

Upload record on system

Contractor verifies patients are registered in CHCS and Defense Enrollment Eligibility Reporting System (DEERS); updates demographic information as needed. Obtain current, accurate contact information

100% PWS Para 5.1.3.1.2.

Periodic Surveillance/ Customer complaints

Upload information on system

Contractor assists with determinations for specialty care that can be provided within the MTF using Service Availability (Capability) Listings and information systems that link the referral to the appointment to the Access to Care (ATC) category and standard

100% PWS Para 5.1.3.1.3.

Periodic Surveillance/ Customer complaints

Referral appointment

Contractor schedules specialty referral appointments to MTF or ODCS (if allowed) using correct CHCS booking procedures, ATC standards and established clinic capability/ booking protocols.

100% PWS Para 5.1.3.1.4.

Periodic Surveillance/ Customer complaints

Coordinate with specialty referral clinics

Contractor coordinates with specialty referral clinics (e.g., internal MTF, 100% PWS Para 5.1.3.1.5.

Periodic Surveillance/ Customer complaints

Other Direct Care System (ODCS), Veteran’s Affairs clinic, etc) on special patient instructions and tests required prior to appointment.

Provide exact referral appointment

Contractor advises patients of the provider, location, time and day of referral appointments or requests the patient to call back for appointment information if not provided appointment prior to leaving MTF for MTF and ODCS (if permitted) initial specialty care appointments

100% PWS Para 5.1.3.1.6.

Periodic Surveillance/ Customer complaints

Customer service with exact information for referral provider

Contractor ensures patients leave MTF with documentation appropriate for the referred care episode to include information for the referral provider as to where to return referral results as required

100% PWS Para 5.1.3.1.9.

Periodic Surveillance/ Customer complaints submits referrals to the appropriate reviewer

Contractor submits referrals to the appropriate reviewer when required for medical necessity and appropriateness review.

100% PWS Para 5.1.3.1.11.

Periodic Surveillance/ Customer complaints

Right communication

Contractor assists with the management of all referral forms to communication between beneficiaries, primary care manager (PCM) team members, network/outside providers and ancillary health care workers

100% PWS Para 5.1.3.1.14.

Periodic Surveillance/ Customer complaints

Work schedule

The contract personnel provides service to work 0800 to 1700, Monday through Friday, with a one-hour lunch break for an 8-hour work day.

100% PWS Para 3.6.1.1.

Periodic Surveillance/ Customer complaints

Comprehension

The contract personnel provides exact comprehension service to the patient and government management

100% PWS Para 5.1.3.5.

Periodic Surveillance/ Customer complaints

5.0. POSITION DESCRIPTIONS.

5.1 Position Title: Network Access Clerk

5.1.1. Assigned to: 51st Medical Group, Osan AB, Republic of Korea

5.1.2. Qualifications:

5.1.2.1. Education: High school diploma or General Educational Development (GED) equivalent is mandatory.

5.1.2.2. Experience: At least two (2) years of experience within the last five (5) years in health care administration is required.

5.1.2.3. The Prime Contractor shall have a current and valid Business Registration issued by System Award Management web.

5.1.2.4. The Contractor (KN) shall provide a proof documentation of Test of English for International Communication (TOEIC), which was obtained within the last three (3) years, and a score no less than 750. Or TOEIC Speaking Test score 110 or higher

5.1.2.5. Native English speaking/Dependent (U.S Citizen) who is residing in Korea is not required to provide TOEIC Score.

5.1.3. Specific Duties/Tasks:

5.1.3.1. Referral Review/Appointing Function. The contract personnel shall:

5.1.3.1.1. Review initial specialty care and deferred to network primary care referrals for administrative completeness (e.g., TRICARE Operations Manual, Chapter 8, Section 5), covered TRICARE benefit and required tests and pre-work. Coordinates with referring providers in cases where additional referral information is required.

5.1.3.1.2. Verify patients are registered in CHCS and Defense Enrollment Eligibility Reporting System (DEERS);

updates demographic information as needed. Obtain current, accurate contact information (i.e., cell/home phone number).

5.1.3.1.3. Assist with determinations for specialty care that can be provided within the MTF using Service Availability (Capability) Listings and information systems that link the referral to the appointment to the Access to Care (ATC) category and standard. Referrals shall be processed within the time limits outlined in the TRICARE Operations Manual, Chapter 8, Section 5.

5.1.3.1.4. Schedule specialty referral appointments to MTF or ODCS (if allowed) using correct CHCS booking procedures, ATC standards and established clinic capability/ booking protocols. The primary responsibility to notify patients of their specialty care referral authorizations to the Network resides with the RMC. Perform/assist with appointing network specialty care referrals as allowed by the MCSC.

5.1.3.1.5. Coordinate with specialty referral clinics (e.g., internal MTF, Other Direct Care System (ODCS), Veteran’s Affairs clinic, etc) on special patient instructions and tests required prior to appointment.

5.1.3.1.6. Advise patients of the provider, location, time and day of referral appointments or requests the patient to call back for appointment information if not provided appointment prior to leaving MTF for MTF and ODCS (if permitted) initial specialty care appointments.

5.1.3.1.7. Assist team members in providing pre-appointment instructions to patients as indicated by the MTF.

5.1.3.1.8. Print diagnostic reports and treatment profiles if requested for patients to hand carry to a Network/non-network initial specialty care appointment.

5.1.3.1.9. Ensure patients leave MTF with documentation appropriate for the referred care episode to include information for the referral provider as to where to return referral results as required.

5.1.3.1.10. Contact patients as required in the event referral requests are invalid (e.g., non-covered benefits) or disapproved by MTF’s second level reviewer and instruct patients accordingly.

5.1.3.1.11. Submit referrals to the appropriate reviewer when required for medical necessity and appropriateness review.

5.1.3.1.12. Generate and forward referral-related phone consult requests received from patients to the appropriate provider/team.

5.1.3.1.13. RMC staff is not responsible for entering into CHCS/Armed Forces Health Longitudinal Technology Application (AHLTA) initial referrals, referral renewals, referral extensions, or other referral generation activities.

5.1.3.1.14. Assist with the management of all referral forms to communication between beneficiaries, primary care manager (PCM) team members, network/outside providers and ancillary health care workers.

5.1.3.2. Heath Benefits Function. The contract personnel shall:

5.1.3.2.1. Advise all categories of patients of what their referral and health treatment options are as related to their eligibility and beneficiary status as outlined by their TRICARE enrollment or DEERs status.

5.1.3.2.2. Direct patient to Patient Travel Coordinator and assist in advising on travel related benefits.

5.1.3.2.3. Advise on Line-of-Duty, Personal Reliability Program, and Medical Evaluation Board issues as mentioned in AFI 41-210, Patient Administration Functions, and AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation.

5.1.3.3. Referral Tracking Function. The contract personnel shall:

5.1.3.3.1. Track initial specialty care and deferred to Network primary care referrals to include obtaining reports from MTF, ODCS, network, and non-network providers. The primary responsibility to obtain Network and purchased care results will be with the MTF. When follow-up results are received from specialists, ensure they are sent to the referring provider or PCM.

5.1.3.3.2. Document patient appointments in CHCS or approved MTF tracking application with whom, either in the MTF, another MTF, in the Network or with a non-network provider.

5.1.3.3.3. Follow-up with MTF providers who did not complete referral results within required timelines.

5.1.3.3.4. Ensure hardcopy results from other MTFs and from Network/non-network providers are promptly returned to the referring provider or PCM within one business day of receipt from the consulted provider/specialist.

5.1.3.3.5. Prepares monthly referral management data reports as determined by the MTF/Government.

5.1.3.3.6. Provide the referring provider(s) or PCM a monthly list of their referred patients who have not scheduled their initial specialty care appointment for the referring provider/team’s action.

5.1.3.3.7. Utilize RMS and Referral Management System Tracking and Reporting (RMSTR) to track referrals.

5.1.3.4. Customer Service Function. The contract personnel shall:

5.1.3.4.1. Greet patients in a positive and professional manner, and provide appropriate patient education and instructions on their referral and the referral process. Maintain positive and professional communication with members of the MTF. Complaints validated by the Quality Assurance Evaluator (QAE) and Government shall be reported in writing to the contractor from the Contracting Officer for action. Failure of the Contractor to correct validated complaints within seven calendar days of written receipt of validated complaint from the MTF staff/KO/QAE/QASP (Quality Assurance Surveillance Plan) will be considered a failure to perform.

5.1.3.4.2. Patient Sensitivity. Contract personnel shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Contract personnel receiving complaints validated by the QASP shall be subject to counseling and, depending on the nature and severity of the complaint, separation from performing service under this contract.

5.1.3.5. Comprehension: If the Government, at its sole discretion, determines that the language skills of a Contractor employee does not meet the language proficiency skills required of the position, the Government reserves the right to require the Contractor to provide a new Contract employee that does possess the required language proficiency skills required for the position at no additional cost to the Government.

5.2. Requirements for all positions.

5.2.1. The contractor shall ensure that all contract personnel providing services under this contract shall be able to read, write, and speak English and Korean well enough to effectively communicate with all parties and other health care providers. In addition, if the position requires the use of computers (i.e. Windows Office programs: Word, Excel, PowerPoint, Outlook), the contract personnel shall be computer literate.

6.0. APPLICABLE TECHNICAL ORDERS, SPECIFICATIONS, REGULATIONS, AND MANUALS.

Following is a list of basic publications applicable to this performance based statement of work. Additional publications may be listed by call. The Contractor is obligated to follow these publications. The contractor shall comply with AFI 44-102 and Medical Group Instruction (MDGI) 44-119 as well as all applicable Notices to Airmen (NOTAMS), Policy Letters, MTF Guidelines and all Medical Instructions for the 51st Medical Group. These documents are available in the MTF and maintained by the Government. Supplements or amendments to instructions or publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes. The contractor will utilize USFK Form 10 and DD Form 2161 as referenced in this PWS. Department of Defense publications can be found at www.defenselink.mil/pubs or www.dtic.mil/whs/directives.

The Publications have been coded as mandatory or advisory. The Contractor is obligated to follow those coded as mandatory only to the extent that they apply to this contract. Advisory publications may be used for information and guidance but are not binding for compliance.

6.1. Mandatory Publications:

TRICARE MANUALS, http://manuals.tricare.osd.mil/ 32 CFR 199, http://manuals.tricare.osd.mil/ Joint Commission on Accreditation of Healthcare Organizations Manual for Hospitals Accreditation Association for Ambulatory Health Care Manual Air Force Health Services Inspection Criteria AFMS Referral Management User's Guide, https://kx.afms.mil/accesstocare

6.2. DEPARTMENT OF DEFENSE (DOD) REGULATIONS/MANUALS INSTRUCTIONS/DIRECTIVES

DODD 5200.2, DoD Personnel Security Program DODD 5400.11, DoD Privacy Program DODD 5500.07, Standards of Conduct DOD Instruction 6025.18R DoDD 5400.11, DoD Privacy Program DoDD 5500.07, Standards of Conduct

DoDD 8500.01E, Information Assurance DoDD 8570.01, Information Assurance (IA) Training, Certification, & Workforce Mgt DoD 6025.18-R, Health Information Privacy DoDI 1402.5, Criminal History Background Checks on Individuals in Child Care Services DoDI 3020.37, Continuation of Essential DoD Contractor Services During Crises

6.3. AIR FORCE REGULATIONS/MANUALS/INSTRUCTIONS

AFI 31-501, Personnel Security Program Management AFI 33-129, Web Management and Internet Use AFI 33-202, Network and Computer Security AFI 33-322, Records Management Program AFI 41-115, Authorized Health Care and Benefits AFI 41-210, Patient Administration Functions AFI 44-119, Medical Quality Operations AFI 44-176, Access to the Care Continuum Referral Management Center Guide, current edition

7.0. ACRONYMS AND DEFINITIONS

AAAHC - Accreditation Association for Ambulatory Healthcare AF - Air Force AFI - Air Force Instruction AHA - American Heart Association AHLTA - Armed Forces Health Longitudinal Technology Application AOD - Administrative Officer of the Day ATC - Access to Care BHCF - Booked Healthcare Finder CAMH - Comprehensive Accreditation Manual for Hospitals CHCS - Composite Health Care System COR - Contracting Officer's Representative CVS - Contractor Verification System DEERS - Defense Enrollment Eligibility Reporting System DoD/DD - Department of Defense DODI - Department of Defense Instruction FIB PUB - Federal Information Processing Standards Publication FSC - Federal Service Code FSO - Facility Security Officer FTE - Full Time Equivalent GED - General Educational Development HIPAA - Health Insurance Portability and Accountability Act HSI - Health Services Inspection HSPD - Homeland Security Presidential Directive IA - Information Assurance IT - Information Technology KO - Contracting Officer MCP - Managed Care Program MCSC - Managed Care Support Contractor MDGI - Medical Group Instruction MHS - Military Healthcare System MTF - Medical Treatment Facility MTN - Military Training Network NOTAM - Notice to Airmen OMB - Office of Management and Budget PACAF - Pacific Air Forces

POC - Point of Contact PWS - Performance Work Statement QAE - Quality Assurance Evaluator QA&I…