W90VN7-17-T-0011.pdf

SEE ADDENDUM

(No Collect Calls)

W90VN7-17-T-0011 07-Jul-2017

b. TELEPHONE NUMBER

063-470-6488

8. OFFER DUE DATE/LOCAL TIME

01:00 PM 07 Aug 2017

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W90VN79. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

MS. KO, KYONG-OK

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

F2L4MG7150A001

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

411TH CONTRACTING SUPPORT BRIGADE, KOREA

RCO KUNSAN, UNIT #2112

APO AP 96264-2112

UNITED STATES OF AMERICA (THE)

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE F2L4MG 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

8 MDG

SSGT TAYLOR BENJAMIN B

8 MDSS/SGSL, BLDG 421

UNIT 2022

KUNSAN AB

APO AP 96264-2022

UNITED STATES OF AMERICA (THE)

TEL: 782-4242 FAX:

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$7,500,000

NAICS:

621399

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF59

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 184 Hours Licensed Practical Nurse

FFP

BASE YEAR: 29 Sep 17 - 31 Oct 17.

Licensed Practical/Referral Management Nurse for 8th Medical Group at Kunsan Air Base. The Contractor shall provide the non-personal services of Licensed Practical Nurse (LPN) to work in the Referral Management Center (RMC) as described in this Performance Work Statement

(PWS)

FOB: Destination

MILSTRIP: F2L4MG7150A001

PURCHASE REQUEST NUMBER: F2L4MG7150A001

NET AMT

ESTIMATED COST FOR WAR HAZARD LOSSES

FFP

Is Zero(0).

FOB: Destination

1001 2,080 Hours Licensed Practical Nurse

FFP

1ST OPTION YEAR: 1 Nov 17 - 31 Oct 18.

Licensed Practical/Referral Management Nurse for 8th Medical Group at Kunsan Air Base. The Contractor shall provide the non-personal services of Licensed Practical Nurse (LPN) to work in the Referral Management Center (RMC) as described in this Performance Work Statement

(PWS)

ESTIMATED COST FOR WAR HAZARD LOSSES

FFP

2001 2,080 Hours Licensed Practical Nurse

FFP

2ND OPTION YEAR: 1 Nov 18 - 31 Oct 19.

Licensed Practical/Referral Management Nurse for 8th Medical Group at Kunsan Air Base. The Contractor shall provide the non-personal services of Licensed Practical Nurse (LPN) to work in the Referral Management Center (RMC) as described in this Performance Work Statement

ESTIMATED COST FOR WAR HAZARD LOSSES

FFP

3001 2,080 Hours Licensed Practical Nurse

FFP

3RD OPTION YEAR: 1 Nov 19 - 31 Oct 20.

Licensed Practical/Referral Management Nurse for 8th Medical Group at Kunsan Air Base. The Contractor shall provide the non-personal services of Licensed Practical Nurse (LPN) to work in the Referral Management Center (RMC) as described in this Performance Work Statement

ESTIMATED COST FOR WAR HAZARD LOSSES

FFP

4001 2,080 Hours Licensed Practical Nurse

FFP

4TH OPTION YEAR: 1 Nov 20 - 31 Oct 21.

Nurse for 8th Medical Group at Kunsan Air Base. The Contractor shall provide the non-personal services of Licensed Practical Nurse (LPN) to work in the Referral Management Center (RMC) as described in this Performance Work Statement

ESTIMATED COST FOR WAR HAZARD LOSSES

FFP

PWS

PERFORMANCE WORK STATEMENT

REFERRAL MANAGEMENT CENTER

LICENSED PRACTICAL NURSE (LPN) AT

KUNSAN AIR BASE (8TH MEDICAL GROUP),

KOREA

TABLE OF

CONTENTS

SECTION

TIT

LE

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

1.1. INTRODUCTION.

1.2. The Contractor shall provide the non-personal services of Licensed Practical Nurse (LPN) to work in the Referral Management Center (RMC) as described in this Performance Work Statement (PWS) at 8th Medical Group (8 MDG), KUNSAN Air Base, Korea. This service shall contribute to a stable workforce tasked with providing quality health care services to a diverse beneficiary population. The contractor shall review and follow the Air Force Medical Service (AFMS) Referral Management Center User’s Guide, current edition, (currently, version 7) as a reference to understand the purpose and objectives of the AFMS.

1.3. All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, Accreditation Association for Ambulatory Health Care (AAAHC), applicable Department of Defense (DoD) and Air Force-specific regulations, directives, and policies, and military treatment facilities (MTF) specific policies, procedures, and job descriptions. Contractor shall give the highest regard to patient dignity and observe the precepts of the DoD Patient Rights and Responsibilities, and American Health Association’s Bill of Rights for Patients.

1.4. The contractor shall provide services in conjunction with 8 MDG providers to include physicians, nurses, registered and licensed practical nurses, and support personnel. Contractor shall perform essentially the same functions as those required by Air Force 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 provided in civilian treatment facilities of similar size and scope.

1.5. This contract 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 prevailing in relationships between the government and its employees.

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 military treatment facilities (MTFs) located on or near military installations or posts.

2.2. The 8 MDG is a clinic that delivers primary care to approximately 2,600 active duty beneficiaries. Annually, the 8 MDG delivers approximately 24,000 patient visits across primary care services. It is staffed by 7 physicians, 3 nurses, 24 medical technicians, and supported by over 100 personnel. It also refers approximately 2,000 patient visits per year for specialty care and sub-specialty care. The sound provision of those referrals and referral results documentation play a key role in ensuring outstanding continuity of care.

3.1 SCOPE OF WORK.

3.2 The contractor shall provide medical support services at Referral Management Center (RMC) and administrative support for the Medical Treatment Facility (MTF) staff and beneficiaries. The contractor shall ensure patient flow is optimized by processing their referrals to specialty care. The contractor shall maintain or assist with a variety of health record storage and retrieval systems. The contractor shall participate with TRICARE Operations Patient Administration (TOPA) Flight staff in providing, assessing, and improving a wide variety of customer services and relations. Performance shall be according to the requirements contained in this PWS, and professional standards of the Accreditation Association for Ambulatory Health Care (AAAHC).

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, AAAHC, 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 COR or, after duty hours, to the TOPA Flight Commander, Flight Chief (highest enlisted member in the Flight), or the next in the Flight’s chain of command. There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander.

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.

3.3.4. The contractor shall not employ active duty military nor government civilian employees to perform services under this contract.

3.3.5. The Contractor or 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 in the MTF, 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.

3.4.1.5. PHYSICAL SECURITY. The Contractor shall be responsible for safeguarding all medical information provided for Contractor use. At the close of each work period, information shall be secured on the office work site. The contractor must ensure that the protected health information used to perform services of this contract is not removed from this MTF.

3.4.1.6. PATIENT LISTS. Patient lists, no matter how developed shall be treated as privileged information.

Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission of the Chief of Medical Staff or the Health Insurance Portability and Accountability Act (HIPAA) Privacy Officer.

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, Department Chief, 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. 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.

3.5. 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. All contract personnel are required to complete the applicable items on the checklist and turn it in to the designated office. Upon completion of the duty assignment, the contract personnel need to complete an out-processing checklist and return it to the designated office.

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.

3.5.2.1. The 8 MDG orientation shall be completed within 30 days of beginning the performance of this contract.

3.5.3. Annual training requirements. The Contractor shall ensure that contract personnel complete any mandatory annual training requirements in accordance with MTF procedures.

3.5.4. Government unique training. The Government may elect to provide unique Government training to contractors 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. When directed by the contracting officer or the COR, the contractor 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 contractor fails to satisfy the performance commitment after the contractor receives the notice to attend 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 contractor fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first.

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. These systems include but are not limited to:

3.5.5.1. Composite Healthcare Computer System (CHCS) is the military’s world-wide automated medical information system interfaces with 40 plus external clinical and administrative systems.

3.5.5.2. Armed Forces Health Longitudinal Technology Application (AHLTA) contains the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF. In addition, it contains the electronic medical records for MHS beneficiaries.

3.6. MTF HOURS OF OPERATION

3.6.1. The 8 MDG operating hours are from 0800 to 1700, Monday through Friday, 8-hour workday, excluding lunch time.

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: Because the significant majority of patients are American citizens, most Korean holidays are considered duty days unless the Korean holiday falls on a weekend, in which case the duty day resumes on the upcoming weekday. For contractors requesting absences on Korean holidays, please see para 3.7.3. Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holidays listed above. If the area in which a contract employee is scheduled to work is closed due to the holiday 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.

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 during unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise, the contractor shall not invoice the Government for services not performed and the Government will not be liable to the contractors for any such closures. The Contractors will only be paid for the actual hours that were worked.

3.7. HOURS OF PERFORMANCE.

3.7.1. The schedule of performance is discussed in paragraph 3.6.1.

3.7.1.1. The contractor shall not provide overtime duties.

3.7.1.2. The contractor will not pull call.

3.7.2. Unanticipated absences: The COR or their designee will be responsible for communicating with the contractor regarding unanticipated absences, such as due to acute illnesses or injuries that necessitate the contractor to seek care from a medical provider and results in absence from duty.

3.7.3. Absences and leave:

3.7.3.1. 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.

3.7.3.2. Scheduled absences of contract personnel shall be coordinated with the COR at least 2 weeks in advance. Depending on the days or hours scheduled for absence, the COR will determine whether or not the contractor supplies a substitute.

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

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

3.8. LICENSE VERIFICATION AND CREDENTIALS REVIEW OR PRIVILEGING.

3.8.1. See Minimum qualifications for details.

3.8.2. Removal of Contract personnel. At any time during the performance of this contract, the Contracting Officer or COR may remove the contractor if possible harm to government employees or facilitates could occur.

This provision will be used in emergency situations only and not for the purpose of bringing performance issues or other non-urgent concerns to the attention of the contractor.

3.8.2.1. If the need for a removal occurs, the COR will contact the contractor’s point of contact and direct the contractor to remove him/her from the military facility. The contractor shall formally meet with the COR to discuss further. A review of the basis for removal will be made by the Contracting Officer within 3 working days after the COR directed the removal.

3.8.2.2. If, after any investigation deemed necessary by the Contracting Officer and discussions with the contractor’s representative, the Contracting Officer concludes that the contract personnel’s impairment requires permanent removal from performance under the contract, the Contracting Officer 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 contract personnel, the decision of the Contracting Officer will be final. During the period of time between the removal and the final decision of the Contracting Officer, the contractor shall provide a backup/replacement contract HCP in accordance with the term and conditions of this contract.

3.8.3. CONDUCT

3.8.3.1. Contract personnel shall comply with MTF policies regarding personal appearance and conduct.

3.8.3.2. Contract personnel shall abide by federal, state, and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the contract personnel as may be necessary for security and personnel reliability programs. They shall also abide by federal, state, and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act (HIPAA) of 1996. All medical records and reports will remain the property of the Government.

3.8.4. Contract personnel shall not introduce new procedures or services without prior approval of the Department Chief or representative. If disagreements or deviations from protocols or procedures occur, the Department Chief or representative shall be the deciding authority.

3.9. Health and immunization requirements. All contract personnel performing services under this contract shall comply with 8 MDG 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.

3.10. 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.

3.11. RESERVED

3.12. Contractor Verification System (CVS).

3.12.1. The Contractor shall comply with agency personal identity verification procedures known as the CVS.

3.12.2. 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.

3.12.3. 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 Contract Officer Representative for this contract. The Government reserves the right to amend or supplement these provisions pursuant to the Changes clause in the contract.

3.12.4. In-processing Requirements. Contractor personnel are prohibited from performing services under this contract absent the compliance with the in-processing requirements of the MTF.

3.12.4.1. For every contract service provider, the FSO shall provide the following information to the TA for input into the 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).

3.12.4.2. 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.

3.12.4.3. 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 contract service provider’s user ID and password.

3.12.4.4. 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.

3.12.4.5. 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.

3.12.4.6. 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, Social Security Card, Military ID, Contractor Company ID with picture and expiration date, VISA charge card with picture imprinted, and passport.

3.12.4.7. 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.

3.12.4.8. 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 Pacific Regional Contracting Office.

3.13. QUALITY MANAGEMENT

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

3.13.2. The Contractor shall ensure that all contract employees 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; inappropriate prescriptions; patient customer service comments; Contractor relationship with hospital staff/Government contracting personnel; compliance with hospital healthcare policies and procedures.

5.0. POSITION DESCRIPTIONS.

5.1 Position Title: Referral Management Center Licensed Practical Nurse (LPN)

5.1.1. Assigned to: TRICARE Operations and Patient Administration (TOPA) Flight Referral Management Center at the 8th Medical Group (8 MDG), Kunsan Air Base, Republic of Korea.

5.1.2. RESERVED

5.1.3. Qualifications

5.1.3.1. Education: Education beyond High School plus the education relating to the nursing license.

5.1.3.2. Licensure/Certification/Registration: At minimum,

- Possess a current, valid and unrestricted state LPN license in at least one U.S. state or territory

OR

- Possess a current Registered Nurse license that is issued by the South Korean Ministry of Health and Welfare

5.1.3.3. Experience: At least 2 years of continuous employment with a single company which applies the nursing skills.

5.1.3.4. Language Requirement: Contractor shall read, understand, speak and write English. Korean contractor shall read, understand, speak and write both English and Korean well enough to effectively communicate with patients, coworkers and health care providers without language-related interruptions. The foreign national must have a TOEIC score above 550.

5.1.3.4.1 The LPN shall possess excellent oral and written communication skills, interpersonal skills, and have working knowledge of computers, specifically the internet, Microsoft Windows, Word, Access, PowerPoint and Excel.

5.1.3.5. Expertise: The contractor performing this duty shall be knowledge in general medical ethics, health records administration, telephone etiquette, office management methods, excellent communications and customer service skills, strong organizational background and computer operations to include Microsoft Windows and spreadsheet type of application, such as Microsoft Excel. Personnel shall understand the importance of deadlines.

5.1.4. Specific Duties/Tasks:

5.1.4.1. SPECIFIC RMC FUNCTIONS - REFERRAL APPOINTING. The RMC falls under the direction and guidance of the TRICARE Operations and Patient Administration Flight Commander and shall:

5.1.4.2. Review all new referral consults (those originating from patient visits, picked up from the clinics or printed at the RMC, for the TRICARE Managed Care Support Contractor (MCSC), emailed, in Referral Management System website, CHCS, AHLTA or faxed to the RMC) to ensure that each includes the following minimum information:

Patient’s name FMP/Sponsor’s social security number Patient’s date of birth Home phone/work phone Originating clinic Specialty clinic being referred to Specific provider if so requested and contact for that provider Originating provider’s name, phone number, and clinic Point of contact at the clinic if the provider is not available Provider’s facsimile number Status of patient (Prime, Plus, Standard, Medicare) Number of visits authorized Time frame for consults

Brief summary of reason for consult ICDB and CPT code(s), if required

5.1.4.3. If the consult does not include the items listed in 5.1.4.2, the RMC LPN shall fill much data as possible before returning the consult to the originating provider.

5.1.4.4. Appoint patients on referrals they receive the same day the referrals are requested and within 30 minutes of arrival in the RMC.

5.1.4.5. Make every effort to book appointments within Access to Care (ATC) standards within the 8 MDG MTF, another MTF or to a host nation hospital at least 90 percent of the time. ATC standards are:

emergency transport for “STAT,” within 72 hours for “ASAP (as soon as possible), and within 28 days for “Routine” specialist appointments.

5.1.4.6. Use information systems that link the referral to the appointment to the ATC category and standard.

5.1.4.7. Advise the patient of the provider, location, time and day of the referral appointment prior to the patient leaving the facility.

5.1.4.8. For MTF referrals, direct the patient to call back on the next business day for appointment information if the patient is not provided appointment prior to leaving MTF. If the patient does not call back within one business day, the RMC staff shall contact patient within three business days to book the appointment.

5.1.4.9. Book specialty care appointments to other MTF’s as needed, and when the patient has completed the visit, ensure that the referral result has been reviewed by the referring provider.

5.1.4.10. Book specialty appointments to Network providers and ensure that the referral result has been reviewed by the referring provider.

5.1.4.11. Provide monthly reports that show patients requiring referral care were treated with ATC standards.

5.1.4.12. Together with the RMC team members, track all 100% of referral requests and results going out of and into the MTF in the Composite Healthcare Computer System (CHCS) system and on the 8 MDG

“Referrals Tracking Database.”

5.1.5 HEALTH BENEFITS FUNCTIONS. The RMC staff shall:

5.1.5.1 Advise all categories of patients of what their referral/health treatment options are as related to their eligibility and beneficiary status (AD, Prime, Standard, civilian).

5.1.5.2 Advise on travel benefits and making travel arrangement with the Theater Patient Movement Requirements Center using the TRANSCOM Regulating and Command and Control Evacuation System if patient agrees to care at another Direct Care System MTF that is over 100 miles away and when military aircraft is used.

5.1.5.3 Advise and track on all patient categories (AD, Prime, Standard, and Civilian) that are admitted/referred as inpatients to local MOU hospitals.

5.1.6 REFERRAL TRACKING. The RMC staff shall:

5.1.6.1 Use the 8 MDG “Referrals Tracking Database” to document referrals activity, the receipt of referral results, and filing of those results into the pertinent patient’s medical record for 100% of referrals processed.

5.1.6.2 Track referrals to include obtaining reports from MTF, Direct Care System, and network/non-network providers within established standards.

5.1.6.3 Document patient’s appointment, with whom, either in the MTF, another MTF, in the Network or with a non-network provider.

5.1.6.4 Document the name of the referring provider/PCM and MTF for purposes of returning specialty results to the referring provider/PCM.

5.1.6.5 The RMC team members, track all 100% of referral requests and results going out of and into the MTF in the Composite Healthcare Computer System (CHCS) system and on the 8 MDG “Referrals Tracking Database.”

5.1.6.6 Follow-up with MTF providers who did not complete referral results within 72 hours of the referral episode at 4 working days after the referral episode. Ninety percent of the results shall be completed by 4 working days and 100% by 30 calendar days.

5.1.6.7 Ensure that results from other MTFs are returned to the referring provider in CHCS and/or AHLTA and to the medical record within 72 hours of the referral episode; notify the referring provider of the result via email, and by physically visiting and notifying the provider.

5.1.6.8 Ensure that results from Network/non-network providers are returned to requesting provider (internal or external) and to the medical record within 10 business days of the kept routine specialty encounter and within 24 hours for preliminary reports on urgent/emergent situations.

5.1.6.9 Follow-up with all Direct Care providers who did not complete referral results at 4 working days after the completion of the referral encounter, daily until the complete results are received, signed, acknowledged by the referring provider, and filed into the patient’s medical record.

5.1.6.10 Follow-up with Network/Non-Network providers who did not complete referral results at 11 working days after the completion of the referral, daily until the complete results are received, signed, acknowledged by the referring provider, and filed into the patient’s medical record.

5.1.6.11 Maintains and tracks referral records, referral results, follow-up referral results, and initiates the routing process to obtain provider’s acknowledgement of results receipt. Specifically, contractor will route the results for provider’s signature, stamp and date. The “RMC Stamp” provided by the 8 MDG will be utilized to initiate this process, and working in conjunction with the Patient Administration staff, oversees the processes to ensure that all referral results are filed into the patient’s original medical record with 100% of results containing the referring provider’s acknowledgement completed.

5.1.6.12 Provide monthly reports showing compliance percentage for MTF, other MTF, and Network/non- network providers’ referral return rate. The RMC shall maintain and provide monthly statistical reports, due by the 15th of the following month. The reportable information and data points may change, but the below entries represent an example:

5.1.6.12.1 Total consults received per specialty broken down into beneficiary category.

5.1.6.12.2 Total consults per provider and specialty.

5.1.6.12.3 Disposition of consults and reasons for deferral and denial.

5.1.6.12.4 Breakdown of time periods to access each specialty, internally and externally.

5.1.6.12.5 Total consults denied access to the MTF.

5.1.6.12.6 Rate of return for Direct Care System (72 hours) and Network/non-network providers (10 days) specialty reports.

5.1.6.12.7 Total recaptured care directed to the MTF.

5.1.7 REFERRAL REVIEW. The RMC staff shall:

5.1.7.1 Review the referral for the following

areas: - - Suitability

- Administrative and clinical completeness

- Covered TRICARE/CHAMPUS benefit for the specific patient via authorizations from MCSC required tests and pre-work

5.1.7.2 Submit referrals to non-network provider to MCSC via the fiscal responsible entity for medical necessity/appropriateness review.

5.1.7.3 Contact patient in event referral request is invalid, disapproved by second level review/MCSC and reschedule patient as soon as possible or instruct patient of other health care options.

5.1.8 COORDINATION FUNCTIONS. The RMC LPN shall assist the TOPA Flight Commander:

5.1.8.1 Recommend where referral will be treated based on rule sets/MOUs/local market conditions, and on MTF capabilities.

5.1.8.2 Arrange travel orders, and non-medical attendants as required.

5.1.8.3 Ensure patient leaves MTF with all necessary documentation appropriate for the referred care episode and the referral provider knows where to return his/her results; goal is patient has tests and paper work before leaving MTF.

5.1.9 CUSTOMER SERVICE. The RMC staff shall:

5.1.9.1.1 Relieve requesting provider from as many administrative burdens as possible.

5.1.9.1.2 Provide the MTF referring provider with referral results.

5.1.9.1.3 Get the right patient to the right service/provider within Access to Care (ATC) standards.

5.1.9.1.4 Serve as the “central clearing house” for providers and patients needing help with referrals.

5.1.10 Performance Qualification for LPN. Administrative – Basic knowledge level includes: principles of customer service, TRICARE, quality control and risk management, medical terminology, medical forms and records management, anatomy and physiology, guideline for release of medical information, medical and legal ethics, infection control concepts, applicable systems technology, supply procedures, and information systems.

5.1.11 NURSING.

5.1.11.1 For referrals that generate results as related to diagnostic testing (labs and diagnostic imaging), pharmaceuticals prescription by Korean providers, progress check visits, profiles, duty restrictions and placement in quarters, coordinate with the referring provider or hi/her nurse, and place telephone consults and/or follow-up appointment with the patient to discuss treatment progress.

5.1.11.2 Follows and complies with Air Force, MTF, and section policies and regulations when providing nursing care and treatment to beneficiaries.

5.1.11.3 Attends section’s meeting in-service, and training (excluding military training) on a regular scheduled session.

5.1.11.4 Facilitates professional and patient care activities.

5.1.11.5 Interfaces with the Managed Care Support Contractor (MCSC) and multidisciplinary personnel as need to ensure appropriateness of referrals.

5.1.11.6 Participates in multidisciplinary team activities.

5.1.11.7 Maintains current nursing license, current knowledge of referral management, and documentation of continuing education credits.

5.1.11.8 Demonstrates an ability to express self in all areas of communication, effective listening, and questioning techniques.

5.1.11.9 Provides timely and descriptive feedback regarding referral type and referral volume review issues.

5.1.11.10 Performs data collection and review to identify areas requiring intensive management.

5.1.12 REFERRAL APPOINTING.

5.1.12.1 Determines TRICARE benefit eligibility.

5.1.12.2 Verifies patients are registered in CHCS/DEERS; updates demographic information as needed.

5.1.12.3 Determines health care that can be provided within the MTF using Service Availability Listings (SAL) and information systems that link the referral to the patient’s medical appointment.

5.1.12.4 Schedules specialty referral appointments to MTF, Direct Care System, or Network/non-network providers within Access to Care standards.

5.1.12.5 Coordinates with specialty referral clinics (internal or external) on special patient instructions and tests required prior to appointment.

5.1.12.6 Advises patients of the provider, location, time and day of the referral appointment or request the patient call back for appointment information if not provided appointment prior to leaving MTF.

5.1.12.7 Provides pre-appointment instructions to patients as indicated.

5.1.12.8 Locates referral requests and ensures appropriate documents are available prior to all specialty appointments.

5.1.12.9 Prints diagnostic reports and treatment profiles as necessary.

5.1.12.10 Ensures patients leave MTF with all necessary documentation appropriate for the referred care episode and the referral provider knows where to return his/her results.

5.1.12.11 Contacts patients in event referral requests are invalid, disapproved by second level review and reschedule patients as soon as possible or instruct patients of other health care options.

5.1.12.12 Submits referrals to non-network providers to TSC for medical necessity/appropriateness review.

5.1.12.13 Receives and appropriately forwards clinical phone consult requests from patients.

5.1.13 PROCEDURE GUIDANCE. The contractor shall perform education services compatible with the medical facility's operating capacity and equipment. New services shall not be introduced without prior recommendation, and approval of the medical treatment facility (MTF) Commander or authorized representative.

5.1.14 DUTY ASSIGNMENT. The contractor shall be primarily required to perform administrative services related to referrals requests and processing in the RMC.

5.1.15 OTHER SUPPORT. The contractor shall provide immediate evaluation of emergency problems as they occur and follow established guidelines for seeking assistance.

5.1.16 DOCUMENTATION. The contractor shall prepare all documentation to meet or exceed established standards of the MTF to include but not limited to timeliness, legibility, accuracy, content and signature. Unless approved for delay, the contractor shall meet all suspense dates. Only MTF and Air Force approved abbreviations shall be used for documentation of care in the health care record. These are available at the 8 MDG upon award of contract.

5.1.17 SELF-EVALUATION. The contractor shall participate in a continual process of self-evaluation and strive for excellence in nursing practice.

5.1.18 ATTENDANCE AT MEETINGS. The contractor shall attend and participate in meetings, conferences, and other appropriate meetings as needed.

5.1.19 INFECTION CONTROL AND SAFETY. The contractor shall comply with all MTF infection control and safety procedures, practices, and standards.

5.1.20 Accreditation Association for Ambulatory Health Care (AAAHC). The contractor shall meet all applicable AAAHC standards during the performance of this contract that relate to the administrative processing referrals.

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 well enough to effectively communicate with all parties and other health care providers.