A09_W91QVN-19-R-0115.pdf

SEE ADDENDUM

(No Collect Calls)

W91QVN19R0115

b. TELEPHONE NUMBER

315-755-3369

8. OFFER DUE DATE/LOCAL TIME

01:00 PM 11 Jul 2019

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

12-Jun-2019

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. PAK, KWI-SON

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

F2L4MG8288AW01

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

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 MDSS/SGSM

MATTHEW R. WATTS, TSGT, USAF

KUNSAN AB

APO AP 96264-2022

UNITED STATES

TEL: 315-782-6039 FAX:

FAX:

TEL: 0503-354-9930 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)

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.

W91QVN19R0115

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 2,080 Hours Family Nurse Practitioner

FFP

The Contractor shall provide all labor, materials, tools, equipment, and transportation necessary to recruit, qualify, and retain one (1) Family Nurse Practitioner (FNP) throughout the duration of this contract. The FNP shall provide personal services in accordance with the PWS.

Note: (1) The Contractor shall provide cost breakdown spreadsheet as part of proposal. (2) The Contractor shall propose a fully loaded labor rates which includes all relative cost for performing work in Korea. (This is an all-inclusive price).

FOB: Destination MFR PART NR: Null

PURCHASE REQUEST NUMBER: F2L4MG8288AW01

PSC CD: Q401

NET AMT

0002 1 Job Contract Manpower Report (CMR)

FFP

CMR must be reported by 31 October of each calendar year during the life of the contract as specified Paragraph 5.3 of the PWS.

NOTE: Not to exceed 20 man hours for data collection and report.

(UIC: F2L4MG, 8 MDG, #2022, APO AP 96264-2022)

FOB: Destination MFR PART NR: Null

0003 1 Job DBA Insurance (FFP CLIN)

FFP

The amount listed by the offeror on this CLIN is the fixed price for the DBA insurance premium. Offerors shall refer to the Claims Reporting and Failure to Comply clauses to correctly price this CLIN. The fixed price shall include all DBA insurance premiums and any administrative costs associated with the Claims Reporting and Failure to Comply clauses.

Estimate for War Hazard

FFP

War Hazzard cost is zero.

1001 2,080 Hours OPTION Family Nurse Practitioner

FFP

The Contractor shall provide all labor, materials, tools, equipment, and transportation necessary to recruit, qualify, and retain one (1) Family Nurse Practitioner (FNP) throughout the duration of this contract. The FNP shall provide personal services in accordance with the PWS.

Note: (1) The Contractor shall provide cost breakdown spreadsheet as part of proposal. (2) The Contractor shall propose a fully loaded labor rates which includes all relative cost for performing work in Korea. (This is an all-inclusive price).

FOB: Destination

1002 1 Job OPTION Contract Manpower Report (CMR)

FFP

CMR must be reported by 31 October of each calendar year during the life of the contract as specified Paragraph 5.3 of the PWS.

1003 1 Job OPTION DBA Insurance (FFP CLIN)

FFP

The amount listed by the offeror on this CLIN is the fixed price for the DBA insurance premium. Offerors shall refer to the Claims Reporting and Failure to Comply clauses to correctly price this CLIN. The fixed price shall

OPTION Estimate for War Hazard

2001 2,080 Hours OPTION Family Nurse Practitioner

FFP

The Contractor shall provide all labor, materials, tools, equipment, and transportation necessary to recruit, qualify, and retain one (1) Family Nurse Practitioner (FNP) throughout the duration of this contract. The FNP shall provide personal services in accordance with the PWS.

Note: (1) The Contractor shall provide cost breakdown spreadsheet as part of proposal. (2) The Contractor shall propose a fully loaded labor rates which includes all relative cost for performing work in Korea. (This is an all-inclusive price).

FOB: Destination

2002 1 Job OPTION Contract Manpower Report (CMR)

FFP

CMR must be reported by 31 October of each calendar year during the life of the contract as specified Paragraph 5.3 of the PWS.

2003 1 Job OPTION DBA Insurance (FFP CLIN)

FFP

The amount listed by the offeror on this CLIN is the fixed price for the DBA insurance premium. Offerors shall refer to the Claims Reporting and Failure to Comply clauses to correctly price this CLIN. The fixed price shall

OPTION Estimate for War Hazard

3001 2,080 Hours OPTION Family Nurse Practitioner

FFP

The Contractor shall provide all labor, materials, tools, equipment, and transportation necessary to recruit, qualify, and retain one (1) Family Nurse Practitioner (FNP) throughout the duration of this contract. The FNP shall provide personal services in accordance with the PWS.

Note: (1) The Contractor shall provide cost breakdown spreadsheet as part of proposal. (2) The Contractor shall propose a fully loaded labor rates which includes all relative cost for performing work in Korea. (This is an all-inclusive price).

FOB: Destination

3002 1 Job OPTION Contract Manpower Report (CMR)

FFP

CMR must be reported by 31 October of each calendar year during the life of the contract as specified Paragraph 5.3 of the PWS.

3003 1 Job OPTION DBA Insurance (FFP CLIN)

FFP

The amount listed by the offeror on this CLIN is the fixed price for the DBA insurance premium. Offerors shall refer to the Claims Reporting and Failure to Comply clauses to correctly price this CLIN. The fixed price shall

OPTION Estimate for War Hazard

4001 2,080 Hours OPTION Family Nurse Practitioner

FFP

The Contractor shall provide all labor, materials, tools, equipment, and transportation necessary to recruit, qualify, and retain one (1) Family Nurse Practitioner (FNP) throughout the duration of this contract. The FNP shall provide personal services in accordance with the PWS.

Note: (1) The Contractor shall provide cost breakdown spreadsheet as part of proposal. (2) The Contractor shall propose a fully loaded labor rates which includes all relative cost for performing work in Korea. (This is an all-inclusive price).

FOB: Destination

4002 1 Job OPTION Contract Manpower Report (CMR)

FFP

CMR must be reported by 31 October of each calendar year during the life of the contract as specified Paragraph 5.3 of the PWS.

4003 1 Job OPTION DBA Insurance (FFP CLIN)

FFP

The amount listed by the offeror on this CLIN is the fixed price for the DBA insurance premium. Offerors shall refer to the Claims Reporting and Failure to Comply clauses to correctly price this CLIN. The fixed price shall

OPTION Estimate for War Hazard

PERFORMANCE WORK STATEMENT

Family Nurse Practitioner 8th Medical Group (USAF)

Kunsan Air Base, Republic of Korea

1. GENERAL: This is a personal services contract (as defined by FAR Subpart 37.104) to provide one (1) Family Nurse Practitioner (FNP) with performance at 8th Medical Group, Kunsan Air Base, Republic of Korea. Personal Service Contracts are intended to create an employer-employee relationship between the Government and the individual health care providers only to the extent necessary for providing the health care services required. The performance of health care services by individuals under a personal services contract are subject to day-to-day supervision and control by health care facility personnel comparable to that exercised over military and civil service individuals engaged in comparable health care services. Any personal injury claims alleging negligence by personnel within the scope of performance of the personal services contract shall be processed by DoD in the same manner as claims alleging negligence by DoD military or civil service personnel. The contract does not create an employer-employee relationship between the Government and any corporation, partnership, business association or other party or legal entity with which the individual may be associated. The authority for this contract is 10 United States Code 1089 and 10 United States Code 1091.

1.1 Description of Services/Introduction: The contractor shall provide qualified personnel to provide personal services necessary to perform Family Nurse Practitioner functions as defined in this Performance Work Statement.

1.2 Background: 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 (MTF) located on or near military installations or posts. The military treatment facility may be a clinic, hospital, or medical center. Clinics are outpatient facilities offering primary care or simple specialty care (routine exams, tests, and treatments). Clinics also perform Deployment Related Health Assessments (DRHA), annual Mental Health Assessments (MHA), and non- aeromedical Preventive Health Assessments (PHA). The purpose of the DRHA program is to identify and to address Service members’ health care needs related to deployment. DRHAs assist with the early identification and management of deployment-related health concerns and conditions that may surface in the months before or the months to years after deployment. DRHAs are a vital component of the Air Force’s ability to provide effective care and treatment for members with deployment related health concerns. The purpose of MHA is to identify and assess post-traumatic stress disorder (PTSD), depression, suicidality, and other mental health conditions to include but not limited to risky alcohol use, emotional issues, or social issues that may affect the member’s overall health or capacity to function. The clinic may be a stand-alone site or satellite of a larger clinic, hospital, or medical center.

1.3 Objective: Enhance the quality of care for all healthcare beneficiaries of 8th Medical Group Aerospace Medicine Team.

1.4 Scope: The Contractor shall provide one (1) FNP throughout the duration of this contract.

The FNP shall provide a full range of nurse practitioner services to include but is not limited to: provide general screening, medical care, and examination of patients for routine, acute, and chronic conditions; provide immunizations; diagnose, treat, and counsel patients;

conduct DRHAs, annual MHAs, and PHAs; provide Base Operational Medicine Clinic (BOMC) support; and perform primary care duties that comply with applicable Department of Defense and Air Force policy and guidance, to include required standards of care and clinical practice and guidelines. The FNP shall accomplish all services in accordance with established standards, principles, and ethics of the profession and applicable professional specialty organizations, the Joint Commission (JC) standards, MTF professional standards, The Joint Commission (TJC) standards, applicable Department of Defense (DoD) standards, and shall comply with Air Force Instructions (AFI) 40-701. The FNP will be held accountable for compliance to the standards listed in the current Comprehensive Accreditation Manual for Hospitals (CAMH).

1.5 Period of Performance: The period of performance (POP) shall be for one (1) Base Year of 12 months and four (4) 12-month option years, from the date of award.

Base Period: 25 Sep 2019 – 24 Sep 2020 1st Option Period: 25 Sep 2020 – 24 Sep 2021 2nd Option Period: 25 Sep 2021 – 24 Sep 2022 3rd Option Period: 25 Sep 2022 – 24 Sep 2023 4th Option Period: 25 Sep 2023 – 24 Sep 2024

1.5.1. The FNP shall begin performance in the MTF at the start of the performance period. All Status of Forces Agreements (SOFA) or host nation requirements, health, security, and credentialing/privileging requirements shall be met prior to start of performance by an initial or replacement provider. The FNP is responsible for obtaining all passports, visas, or other documents necessary for the FNP to enter and/or exit the foreign country where performance is required.

1.6 General Information:

1.6.1 Quality Management: The contractor shall have a planned and systematic quality management process for monitoring and analyzing its contract performance to ensure the service is performed in accordance with applicable laws, pertinent regulations, and commercial practices. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The FNP shall comply with the MTF quality management/process improvement activities. The FNP shall participate in the MTF’s Medical Quality Assurance/Risk Management (QA/RM) Orientation.

1.6.2 Quality Assurance: The government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.6.2.1 Inspection: The inspection and acceptance point for all services rendered under this contract will be the Contracting Officer Representative (COR) and/or Gov’t representative per FAR part 46. The performance of the FNP, the quality of services rendered, and any documentation or written material in support of the same, shall be subject to continuous inspection, surveillance, and review for acceptance by the Contracting Officer (KO) or COR.

Any services rendered by the FNP to patients or interaction with military/civilian personnel deemed by the KO to be unprofessional, threatening, and/or dangerous will be grounds for immediate termination for default/cause.

1.6.2.2 Monitoring: 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: FNP not meeting minimum qualification standards; inappropriate prescriptions; patient customer service comments; FNP relationship with hospital staff/Government personnel; and compliance with hospital health care policies and procedures.

1.6.3 Recognized Holidays & Facility Closures: 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. Korean Nationals shall coordinate Korean Holidays as per the 8 FW holiday policy.

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day

1.6.3.1 Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as holidays listed above. If the area in which the FNP is scheduled to work is closed due to the holiday declared by an Executive Order, the FNP shall not report in and payment will not be made for those hours.

1.6.3.2 The FNP shall not provide services on PACAF’s family days, other scheduled “down days”, or days the installation is closed due to inclement weather, military emergencies, or other such acts of God.

1.6.3.3 The FNP shall report to work as scheduled during base exercises, emergencies, or adverse weather conditions which does not result in an installation/facility closure. Contract services are still required during these situations. However, if transit to work is not possible, the FNP shall immediately notify the COR and supervisor.

1.6.3.4 The Contractor shall not invoice the Government for services not performed and the Government will not be liable for any such closures.

1.6.4 Hours of Operation: The MTF hours of operation are from 0800 to 1700 hours Monday through Friday. Duty hours will be dayshift hours, no weekends or federal holidays.

1.6.4.1 Work Schedule: A normal work week is 40 hours per week (8 hours per day) Monday through Friday. The FNP shall conduct business between the hours of 0800 to 1700 (including one (1) hour unpaid lunch) Monday through Friday. The FNP will be compensated only for time actually devoted to delivery of services in this contract. There may be occasions when mission and workload changes require employees to adjust work schedules to meet demand. The COR will be responsible for communicating with the FNP regarding scheduling issues. All overtime must be approved by 8th Medical Group Commander.

1.6.4.2 Overtime: The FNP shall not provide overtime or on-call duties under this contract. In any instances where the Government supervisor directs the FNP to remain on duty in excess of their scheduled shift due to an unforeseen emergency or to complete patient treatment where lack of continuity of care would jeopardize patient health, the FNP shall remain on duty. This provision is not intended to apply to the time required to complete routine tasks which should be completed as part of the normal shift (e.g. completion of paperwork or routine administrative tasks at the end of a shift). The Supervisor will adjust the FNP’s schedule for additional hours such that the number of hours on the contract is not exceeded and no overtime is required.

1.6.4.3 Absences: Absences are to be coordinated with and at the discretion of the direct supervisor. Unscheduled absences due to illness or emergency must be coordinated with the COR and direct supervisor as early as possible but no later than two (2) hours prior to the start of scheduled shift. Scheduled absences shall be coordinated with the COR and direct supervisor at least 30 calendar days prior to anticipated leave. All absences, scheduled or unscheduled, are unpaid absences. The Contractor/FNP are responsible for submitting accurate invoices.

1.6.4.4 Continuity of Services/Replacement Staff: The Contractor shall notify the COR in writing when he/she cannot provide a replacement FNP. The 8th Medical Group will adjust staffing to cover contractor leave dates.

1.6.4.5 Services During Crisis: Performance of services during crisis declared by the National Command Authority or Overseas Combatant Commander may be required to support an activation or exercise of contingency plans outside the normal work hours. Emergency situations (e.g. accident and rescue operations, civil disturbances, natural disasters, military contingency operations, and exercises) may necessitate the FNP provide increased or reduced support as determined by the Contracting Officer. The Government will negotiate an equitable adjustment with the Contractor for the cost of these emergency requirements.

1.6.5 Place of Performance: Work performed under this contract will be performed at 8th Medical Group Government-Owned facilities at Kunsan Air Base, Republic of Korea only.

1.6.6 Type of Contract: The Government contemplates award of a Firm-Fixed Price contract.

1.6.7 Security Requirements:

1.6.7.1 National Agency Check: The FNP shall have at minimum favorable National Agency Check (NAC) prior to POP. The FNP shall comply with the requirements of DoD 5200.2-R Personnel Security Program, AFI 33- 119 Electronic Mail (e-mail) Management and Use, AFI 71-101 Volume 1 Criminal Investigations, and AFI 71-101 Volume 2 Protective Service Matters. The FNP shall report any information or circumstances of which they are aware that may pose a threat to the security of DoD personnel, contract personnel, resources, and classified or unclassified defense information to the Chief Pharmacology services.

1.6.7.2 Identification Badge: The Contractor and FNP shall comply with local installation and MTF personnel identification and access requirements. While on site, each FNP shall wear visible security badge identification (provided by the military installation or MTF) on the front of his/her outer clothing. The badge shall show the full name, title, and the word “CONTRACTOR” on the front. The FNP shall turn in all identification badges to the COR upon termination of services under this contract. The FNP shall immediately report any lost or stolen badges to the COR.

1.6.7.3 Vehicle Registration: The MTFs are located on restricted access military installations.

The Contractor/FNP shall comply with the local installation requirements for vehicle registration and operation on the military installation. The FNP must register their vehicles with the office responsible for vehicle registration 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. A personally owned vehicle (POV) is not required. It is up to the FNP whether or not he/she wants to bring his/her POV. It is the FNP’s responsibility to pay with his/her own funding out-of-pocket for all related costs for shipping a POV. The FNP may also decide to procure a POV in-country with his/her own funding out-of-pocket. All vehicles are subject to search. The FNP may encounter long delays for vehicle inspection and identification checks upon entering and exiting the installation. The Government will not reimburse the FNP for time spent at installation checkpoints. The FNP must plan accordingly and report to work at their scheduled duty time, at their appointed place of duty within the MTF. The FNP shall follow installation procedures for removal and turn-in of the vehicle decal upon termination of services under this contract.

1.6.7.4 Safeguarding Government Property/Information: The FNP shall be responsible for safeguarding all government equipment, information, and property (including controlled forms) provided for the FNP’s use. The FNP shall safeguard information of a confidential or sensitive nature. All patient related information is considered confidential and sensitive. If working remotely during contingency, FNPs are prohibited from reproducing patient information in any way (this includes printing). Neither the Contractor nor the FNP 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 FNP may be required to provide testimony or disposition in cases of due process action.

At the close of each work period government facilities, equipment, and materials shall be secured.

1.6.7.5 Key Control: The Contractor shall establish and implement methods of making sure all keys/key cards issued to the FNP by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE: All references to keys include key cards. No keys issued to the FNP by the Government shall be duplicated. The Contractor shall be financially responsible for the replacement of any lost keys and any associated locks. The FNP shall turn-in any issued keys when they no longer require access to locked areas. The FNP shall immediately report any occurrences of lost or duplicate keys/key cards to the COR.

1.6.7.5.1 In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the Contracting Officer, re-key or replace the affected lock or locks;

however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

1.6.7.5.2. The Contractor shall prohibit the use of Government issued keys/key cards by any persons other than the assigned FNP. The FNP shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than the FNP engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

1.6.8 Special Qualifications:

1.6.8.1 Education: The FNP shall possess a Master degree of Science in Nursing from an accredited educational institution authorized to grant Master’s degrees.

1.6.8.2 License: The FNP shall possess and maintain throughout the course of the contract a current, valid, and unrestricted (with no limitations, stipulations, or pending adverse actions) U.S. issued license to practice as a Nurse Practitioner. License must be recognized and accepted by the state or territory of practice.

1.6.8.3 Certifications:

1.6.8.3.1 The FNP shall possess and maintain throughout the course of this contract a current American Heart Association or American Red Cross certification in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS).

1.6.8.3.2 The FNP shall write prescriptions for controlled substances, therefore, he/she shall have a current Drug Enforcement Agency (DEA) certificate or Controlled Drug Substance number as appropriate.

1.6.8.4 English Language Requirement: The FNP shall be able to read, speak, understand, and write English well enough to effectively communicate with patients, coworkers, and other healthcare providers without language barriers. A foreign national candidate must have a Test of English for International Communication (TOEIC) score equal to or greater than 550.

1.6.8.5 Prior Experience: The FNP shall have at least one (1) year of experience as a Nurse Practitioner in English- speaking setting within the last five (5) years. Must have experience performing acute and chronic care and treating patients of all ages for routine, urgent, and emergent diseases and injuries. Experience in case management, discharge planning, utilization management, process improvement, and personnel management is required.

1.6.8.5.1 Knowledge: The FNP shall have a working knowledge of commonly used pharmacological agents used in patient treatment, the desired effects, side effects, and complications of their use as well as the accurate administration and dosage of the pharmacologic agent. Knowledge of the administrative requirements for proper documentation of patient’s condition including disease progress, acknowledgement of teaching, and follow-up care. Knowledge of computer operations and proficiency in the use of basic word processing software such as Microsoft (MS) Office, MS Outlook (e-mail), MS Excel, MS PowerPoint, MS Word, and Adobe Acrobat. Knowledge of and proficiency in the use of the following computer systems is preferred but not required: Composite Health Care Systems (CHCS), Armed Forces Longitudinal Technology Application (AHLTA), Aeromedical Services Information Management System (ASIMS), and Preventive Health Assessment and Individual Medical Readiness (PIMR).

1.6.8.5.2 Skills: The FNP shall be skilled in analyzing and defining healthcare needs of a defined population using standardized assessment tools. Skill in setting up, operating, and monitoring specialized medical equipment such as cardiac monitoring devices, ECG units, oxygen analyzers, nebulizers, and other unit specific equipment.

1.6.8.5.3 Abilities: The FNP shall possess the ability to review and understand a wide range of medical disorders, conditions, and disease processes, evaluations, and diagnoses for the adult patient to include in-person and via telephone assessments. Ability to educate and apply preventive health and disease management principles with a primary focus on treatment and prevention protocols. Ability to meet administrative requirements for proper documentation of patient’s condition including disease progress, education, and follow-up care. Ability to use problem-solving techniques to articulate medical requirements to patients, family members, caregivers, and medical as well as non-medical staff in a professional and courteous way. Ability to effectively communicate and collaborate with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization. Ability to effectively communicate in writing (both handwritten and electronically) to provide accurate documentation, recommendations, and conclusions to health care professionals and senior management. Ability to recognize those conditions beyond his/her level of training and/or experience and consult a physician in an appropriate and timely manner.

1.6.9 Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The COR may meet periodically with the contractor to review the FNP’s performance. These meetings shall be at no additional cost to the government.

1.6.10 Contracting Officer Representative (COR): The COR will be identified by separate letter. A letter of designation issued to the COR, a copy of which is sent to the Contractor, reflect the responsibilities and limitations of the COR, especially with regard to changes in cost or price estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.6.11 Confidentiality of Information: Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced, or otherwise available to the FNP 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 FNP shall not release any of the above information without prior written consent of the KO. The Contractor/FNP shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication. The FNP shall prepare medical records, forms, and documents as required in accordance with the regulations and established guidelines listed in the contract. The FNP shall comply with all Air Force Medical Service (AFMS) requirements for safe keeping, handling, release, and disposal of any of the above information.

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

1.6.13 Professional Liability: Pursuant to 10 United States Code 1089 (a), DoD shall process any personal injury claim alleging negligence by the FNP within the scope of the FNP’s performance under this contract as claims alleging negligence by DoD military or civil service personnel. The FNP is not required to maintain medical malpractice liability insurance, and the Government shall not reimburse or otherwise pay for such insurance should any be purchased. If any suit or action is filed or any claim is made against the FNP, which occurred as a result of work performed by the FNP under this contract, the FNP shall immediately notify the Contractor, the COR, and the Contracting Officer and promptly furnish them copies of all pertinent documents received. The FNP shall cooperate with the Government and authorized Government representatives without further compensation in the processing, review, settlement, or defense of the suit, action, or claim to settle or defend the claim and to represent the FNP in or take charge of any litigation involved in such an action.

1.6.14 In/Out-Processing, Orientation, and Training: The FNP shall complete all specified orientation programs, initial and annual training requirements, and comply with all MTF policies, procedures, productivity standards, and instructions as provided by the MTF.

1.6.14.1 In/Out-Processing: At start of performance period, the FNP shall obtain an in-processing checklist from the COR. The FNP is required to complete the applicable items on the checklist and turn it in to the designated office. Upon completion of the contract (contract expiration/termination), the FNP shall obtain and complete an out- processing checklist and return it to the designated office.

1.6.14.2 Orientation: The FNP shall attend a Government paid orientation aimed to familiarize the FNP with the policies and procedures of the medical facility, assigned department, and specific unit. The Orientation shall be completed within the first 30 days of contract performance.

1.6.14.3 Training: The FNP shall complete all mandatory annual training requirements in accordance with 8th Medical Group’s policies and procedures. The FNP shall be required to meet Continuing Medical Education (CME) requirements. The FNP shall complete Occupational Safety and Health Administration (OSHA) required training. The FNP will actively participate in the MTF’s safety and health management system and comply with OSHA standards and report all workplace hazards, accidents, and near-miss events to the supervisor and Medical Department Activity Safety Manager. The Government may elect to provide unique Government training. The FNP who have any interaction with the MTF computer systems must receive training for the applicable system(s). The systems include but are not limited to: CHCS and AHLTA. The COR will coordinate the necessary training.

Training will be on-site and during normal work hours. When directed by the KO, the FNP shall attend all such training in a paid status as part of normal services required and billed under the contract.

1.6.15 Health and Immunization: The FNP performing services under this contract shall comply with 8th Medical Group health and immunization requirements. The requirements comprise of a Hepatitis B series to include a positive Hep B titer, MMR (two shots or a positive titer), Varicella (two shots or a positive titer), Tb screening (initial two-step), and seasonal influenza. The expense to comply with this requirement shall be borne by the Contractor at no additional cost to the Government. Certification that the FNP has completed the requirement shall be provided to the COR within five (5) working days after contract award. The certification shall state the date on which the examination was completed, the name of the medical provider that performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “{FNP’s full name} is free from contagious diseases to include, but not limited to Tuberculosis, Hepatitis, and Venereal Disease”.

1.6.15.1 Pregnancy: If the FNP is pregnant, she must immediately notify the COR. The MTF Employee Health Office will provide information concerning any work hazards in the area to the Contractor/FNP. The Contractor shall provide a replacement FNP while the primary FNP is absent due to maternity leave.

1.6.15.2 Emergency Healthcare: 8th Medical Group will provide emergency health care to the FNP for injuries or life threatening medical emergencies occurring while on duty at the MTF.

The Contractor shall reimburse the Government for such services at the full reimbursement rate as billed by the MTF.

1.6.16 Media and Other Inquires: The Contractor/FNP 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 the Administrative Officer of the Day (AOD) after duty hours. 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.

1.7 Administrative Matters:

1.7.1 Contractor Representative: The Contractor shall designate in writing, a primary point of contact (POC) for contract coordination and implementation not later than five (5) business days after receiving notice of contract award. The Contractor shall notify the KO of changes in the primary point of contact at least five (5) working days prior to the change or as soon as need for change is known. This notification shall be in writing and shall state the full name, phone number, and email address of the contractor’s point of contact.

1.7.2 HIPAA Compliance: The FNP shall abide by all requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Public Law 104-191) as codified at 45 CFR Part 160 and part 164 subparts A and E and implemented by DoD 6025.18-R regarding the privacy and confidentiality of health records and information being provided and shared under the resulting contract. The FNP shall also comply with the Business Associate Agreement (BAA) listed in the Appendix A under Privacy of Protected Health Information and herby incorporated into this Performance Work Statement as Attachment 2.

1.7.2.1 The FNP shall abide by federal, state, and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the FNP 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 shall remain the property of the U.S. Government.

1.7.2.2 Patient Sensitivity: The FNP shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. The FNP receiving complaints validated by the COR shall result in counseling, Contract Deficiency Report, and/or termination depending on the nature and severity of the complaint.

1.7.3 Criminal History Background Check: The FNP involved in the delivery of health care to children under the age of 18 on a frequent and regular basis shall meet the requirements of the Crime Prevention Act of 1990.

1.7.4 The FNP shall not introduce new procedures or services without prior approval of the Health Care Integrator or representative. If disagreements or deviations from protocols or procedures occur, the Chief of Medical Staff or representative shall be the deciding authority.

1.7.5 The FNP providing medical services under this contract shall ensure his/her rubber stamp contains his/her full name, degree, title, DEA or Controlled Drug Substance number, and the word “CONTRACTOR”. The stamp shall be placed on all forms and documentation having the FNP’s signature.

Example:

John J. Jones, APRN, BC Family Nurse Practitioner DEA #123456 Contractor

1.8 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.

1.8.1 Anti-Terrorism (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.

1.8.2 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.

1.8.3 Local Antiterrorism Measures: The contractor and all associated sub-contractors shall brief all employees on the local antiterrorism measures (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.

1.8.4 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.

1.8.5 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.

1.8.6 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.

2. DEFINITIONS AND ACRONYMS:

2.1 DEFINITIONS

2.1.1 AMBULATORY DATA SYSTEM (ADS). This computer system produces forms on which the providers identify the appropriate billing codes for diagnoses and procedures for each patient.

2.1.2 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.

2.1.3 COMPOSITE HEALTHCARE COMPUTER SYSTEM (CHCS) is the military’s world-wide automated medical information system interfaces with 40 plus external clinical and administrative systems.

2.1.4 CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

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

2.1.6 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S.

Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.7 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.8 DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.9 FUNCTIONAL REQUIREMENTS EVALUATOR DESIGNEE (FRED): The FRED is an individual designated IAW AFI 41-209 to monitor schedule compliance (days/hours worked), inspect deliverables (work performance), and submit monthly performance documentation to the COR to ensure performance is compatible with contract and mission objectives.

2.1.10 KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.11 PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.12 QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.13 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

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

2.1.15 SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.16 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.17 WORK WEEK. Monday through Friday, unless specified otherwise.

2.2 ACRONYMS:

ACOR Alternate Contracting Officer's Representative ADM Ambulatory Data Module ADS Ambulatory Data System AFARS Army Federal Acquisition Regulation…