A.09.03_W91YU0-15-T-0229-01.docx

W91YU0-15-T-0229

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 0002

The CLIN extended description has changed from:

BASE: Field Hours 1 October 2015 - 30 September 2016

To:

BASE: Field Hours 1 April 2016 - 30 September 2016.

The following have been modified:

PWS

PERFORMANCE WORK STATEMENT

AMBULANCE STAFF SERVICES

WILLIAM BEAUMONT ARMY MEDICAL CENTER

EAST FT. BLISS, TX

1. GENERAL.

1.1. Description of Work. The Contractor shall provide the experienced professional services of Emergency Medical Technicians (EMT), Emergency Medical Technician-Paramedics (EMT-P), and a Senior Level EMT-Paramedic. Administrative Support Assistant to work in support of William Beaumont Army Medical Center, East Fort Bliss. The location of service is hereafter known as Military Treatment Facility (MTF). The Contractor Personnel performing this service are hereafter referred to as the Health Care Provider (HCP).

1.1.1. The Ambulance Services include, but are not limited to: advanced life support ambulance service, transportation of remains, administrative transfers, transports to and from aero-medical evacuation sites, patient transports, and field ambulance services as defined in Army Regulation (AR) 40-3, Chapter 13 - Emergency Medical Services. The AR can be found at http://www.apd.army.mil.

1.1.2. This contract is a personal services contract for the EMT, EMT-P and a Senior Level EMT-P and is intended to create an employer-employee relationship between the Government and the individual contract healthcare providers only to the extent necessary for providing the healthcare services required under this contract. The performance of healthcare services by the individual contract healthcare providers under a personal services contract are subject to day-to-day supervision and control by healthcare facility personnel comparable to that exercised over military and civil service healthcare providers engaged in comparable healthcare services. Any personal injury claims alleging negligence by the individual contract healthcare providers within the scope of the healthcare provider’s performance of the personal services contract shall be processed by Department of Defense (DoD) in the same manner as claims alleging negligence by DoD military or civil service healthcare providers. The contract does not create an employer-employee relationship between the Government and any corporation, partnership, business association, or other party or legal entity with which the contract health care provider may be associated. The authority for this contract is 10 United States Code 1089 and 10 United States Code 1091.

1.1.3. Performance Measurements Requirement Summary. The following performance objectives and measures will be used to evaluate Contractor performance and compliance under the contract. This information will be used to prepare annual past performance evaluations. See Exhibit 1, Quality Assurance Surveillance Plan (QASP), for additional details.

Provide patient care IAW MTF policies and procedures. PWS 5.

1.1.4. The inspection and acceptance point for all services rendered under this contract will be by the Department of Emergency Medicine. The performance by the HCP, 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 Contracting Officer Representative (COR) or designated representative. Any services rendered by the HCP(s) to patients or interaction with military/civilian personnel deemed unprofessional/threatening/dangerous by the Department Chief will be considered as grounds for immediate removal of the HCP and termination under the clause 52.212-4 (m) Termination for Cause. Quality Assurance procedures established by the Military Treatment Facility (MTF) shall be used for continuous monitoring. Other performance evaluation factors will be monitored that are not quantified by numerical measurements, which include: administering medications as provided by the MTF; Contractor providing personnel not meeting the minimum qualification standards; administering inappropriate medications; patient customer service comments; HCP and Contractor relationship with clinic staff/government contracting personnel; compliance with clinic policy and procedures. Services provided by the HCP shall be reviewed and rated in accordance with the MTF by-laws and Joint Commission (JC) standards. A poor rating shall be grounds for immediate removal of the HCP(s).

1.1.5. HCP’s will comply and meet all patients and customer service, HCP’s will meet and maintain a high level of patient and customer satisfaction and all times.

1.2. Requirements and Qualifications.

1.2.1. The Contractor shall ensure that all Contractor personnel providing services meet the following requirements:

1.2.1.1. The Contractor shall not employ any individual to provide direct healthcare services who is listed on the Health and Human Services (HHS) list of providers excluded from federally funded healthcare programs. The list may be found at http://oig.hhs.gov/fraud/exclusions.asp.

1.2.1.2. The HCP shall have sufficient skills, knowledge, and experience to perform the specific tasks (see Paragraph 5. of this Performance Work Statement).

1.2.1.3. The Contractor and the Contractor personnel shall abide by all clinical standards, rules, and procedures including requirements for licensure, credentialing and quality assurance programs.

1.2.1.4. The Contractor shall ensure its Contractor personnel perform and maintain required training indicative towards working in and around an MTF setting.

1.2.1.5. Contract personnel shall provide proof of U.S. Citizenship or otherwise meet the requirements of AR 25-2, Information Assurance.

1.2.1.6. Contractor personnel shall not have been convicted of a felony.

1.2.1.7. Contractor personnel shall successfully complete a criminal history background check in accordance with paragraph 7.4. of the PWS.

1.2.1.8. Contractor personnel shall be able to read, write, and speak English well enough and enunciate with sufficient clarity to effectively communicate with patients and various HCPs.

1.2.1.9. Possess sufficient initiative, interpersonal relationship skills, and social sensitivity such that the HCP can relate to a variety of patients from diverse backgrounds.

1.2.1.10. Able to operate a personal computer utilizing Microsoft applications, such as Word, Excel, and efficiently utilize an Electronic Medical Record.

1.2.1.11. Contractor personnel shall be required to meet Continuing Education (CE) requirements as determined by the Emergency Medical Technicians (EMT) State of licensure, whichever is more stringent. The Government will not reimburse for these costs.

1.2.2. Qualifications – Emergency Medical Technicians (EMT) shall meet the following qualifications:

1.2.2.1. Requirements. It is the Contractor’s responsibility to ensure this is accomplished in a timely manner. The HCP shall obtain any certification to perform the contract requirements. EMT personnel shall have certification corresponding to the individual's level of training. Each EMT shall possess a valid Texas driver’s license. EMT personnel shall meet all requirements established by the State of Texas or the State of and the National Registry of Emergency Medical Technicians (NREMT). EMT personnel shall be qualified to practice as an EMT in the State of Texas and obtain the National Registry of Emergency Medical Technicians (NREMT) Certification within 180 days of employment. The Contractor shall ensure that if any EMT is not NREMT certified, NREMT certification shall be obtained within 180 days of the date that the individual starts employment under this contract. The HCP shall obtain at his or her expense any permits or licenses to conduct this contract.

1.2.2.2 Certification. EMT Personnel shall have and maintain current Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS). The American Heart Association is the only program accepted. The Contractor shall ensure that if any EMT is not PALS certified, PALS certification shall be obtained within 180 days of the date the individual starts employment under this contract.

1.2.2.3 Experience. EMT personnel shall have a minimum of one year’s EMT experience within the last two years.

1.2.2.4 Dispatcher is required to be Emergency Medical Technician qualified. Dispatcher is required to cover all locations 24/7 for EMS transportation requests to appropriately dispatch and provide directions to all WBAMC ambulance calls.

1.2.3. Qualifications – Emergency Medical Technician-Paramedics (EMT-P) shall meet the following qualifications:

1.2.3.1 Requirements. It is the Contractor’s responsibility to ensure this is accomplished in a timely manner. The HCP shall obtain any certification to perform the contract requirements. EMT-P personnel shall have certification corresponding to the individual's level of training. Each EMT-P shall possess a valid driver’s license. EMT-P personnel shall meet all requirements established by the State of Texas and the National Registry of Emergency Medical Technicians (NREMT). Depending on duty location; EMT-P personnel shall be qualified to practice as an EMT-P in the State of Texas and obtain the National Registry of Emergency Medical Technicians (NREMT) Certification within 180 days of employment. For any EMT-P not NREMT certified, the Contractor shall ensure that NREMT certification shall be obtained within 180 days of the date that the individual starts employment under this contract. The HCP shall obtain at his or her expense any permits or certification to conduct this contract.

1.2.3.2 Certification. EMT-P personnel shall have and maintain current Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS) certifications. The American Heart Association is the only program accepted. The Contractor shall ensure that if any paramedic is not PALS certified, PALS certification shall be obtained within 180 days of the date the individual starts employment under this contract.

1.2.3.3 Experience. EMT-P personnel shall have a minimum of one year’s EMT experience within the last two years. EMT-P personnel shall have a minimum of six months of paramedic experience within the last year.

1.2.3.4 4 Qualifications - Supervisory Program Manager (SPM) is a Senior Level Emergency Medical Technician (EMT) shall meet the qualifications as stated in 1.2.2.1 thru 1.2.2.3 along with management level experience in planning, directing, and evaluating an Emergency Medical Services (EMS) Systems operational, clinical and training performance of front-line EMS staff. The SPM will assist Emergency Department Chief in the oversight of the efforts, actions, and duties of all WBAMC EMS line staff and officers.

1.3. Administrative.

1.3.1. This is not locum tenens procurement; therefore the use of short-term rotating HCPs seriously detracts from continuity of patient care that is of utmost importance. Periods of not less than six months duration shall be provided by any primary HCP working under this contract. Substitutes are permitted during scheduled or unscheduled absences of the primary HCP. The Contractor shall have adequate pre-credentialed/pre-privileged replacement HCPs available in such instances so a lapse in coverage does not occur. Substitutes shall be as qualified and privileged as the primary HCP. Substitutes are not allowed so the HCP can accept another assignment or to meet the needs of the Contractor. The credentialing/ privileging process takes between 30-45 days. Any lapse in coverage may be considered grounds for termination for cause.

1.3.2. In no case shall the total amount of compensation paid to an individual in any year under a Personal Services Contract exceed the full time equivalent rate of $400,000.00 as established under Section 102 of title 3, chapter 2, United States Code. The number of hours one employee can work on a full-time schedule is 1,920 ($400,000/1,920 hours = $208.33/hour).

1.3.3. The use of non-compete conditions in employment agreements or in subcontracts (to prevent loss of personnel by the contractor) effective only during the period of the contract performance is acceptable. However, the use of non-compete conditions in employment agreements and/or in subcontracts that prevent employees and/or subcontractors of the incumbent from being interviewed by, employed, or accepting offers of employment and/or subcontracts by the new contractor on the follow-on contracts is unacceptable. It hinders the government’s ability to accomplish the mission of providing medical care to beneficiaries. Inclusion of such conditions in an employer’s employment agreement and/or subcontracts will result in an offeror’s proposal being unacceptable. Awardee, and their subcontractors, may not include such conditions in employment agreements and/or subcontracts while performing under this contract.

1.3.4. Orientation and Training.

1.3.4.1. Prior to working, HCPs will be provided a Government paid orientation to familiarize HCPs with the policies and procedures of the MTF. Orientation attendance will be required of all HCPs and will be scheduled by the COR or Department Chief during normal duty hours.

1.3.4.2. The Contractor shall ensure that each HCP is are knowledgeable of the policies and procedures of his/her specific place of duty and of the medical activity. The Contractor shall ensure HCPs receive any staff training required by the MTF as a precondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled shift of the HCP.

1.3.4.3. Government Unique Training. The Government may elect to provide unique Government training to HCPs who are performing services under this contract. If the Government elects to provide such training, the Government will provide such training at no additional expense to the Contractor or to the HCP. When directed by the Contracting Officer (KO), HCPs shall attend all such training in a paid status as part of the normal services required and billed under the contract. Such training shall require a performance commitment by the Contractor and the Contractor shall reimburse the Government (by means of a reduction in an invoice) if a HCP fails to satisfy the performance commitment after the HCP receives the unique Government training. The amount of the reimbursement shall be the prorated cost of training, calculated based on the total cost of the training and the number of months by which the HCP fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first. Details of any subsequent training agreement will be agreed upon by all parties, and such training agreements will be designated by modification to the contract.

1.3.4.4. Electronic Medical Record Keeping Systems. The Government will provide training to HCPs in the Electronic Medical Record Keeping Systems and other procedures that the medical activity's staff is required to use. Access to such patient data systems is an "Automated Data Processing Sensitive" position requiring compliance with AR 25-2 and AR 380-67. Refer to the Additional Information section “ADP Security Requirements” in this contract for further guidance. Treatment and care shall be recorded in AHLTA within 72 hours after patient visit. All records generated in the performance of this contract shall remain the property of the government.

1.3.4.4.1. Composite Healthcare Computer System (CHCS) and Armed Forces Health Longitudinal Technology Application (AHLTA). CHCS contains the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF. The Government will provide training to HCPs in the CHCS/AHLTA and/or other procedures that the medical activity’s staff is required to use. Access to such patient data systems is an “Automated Data Processing Sensitive” position requiring compliance with AR 380-19 and AR 380-67.

1.3.4.4.2. 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.

1.3.4.4.3. Training for CHCS/AHLTA and other computer training will be scheduled through the COR prior to the HCPs providing direct patient care. The training will be on-site and during normal duty hours. This training will be at no cost to the Contractor.

1.3.4.4.4. If additional training is needed due to mission changes, the MTF Information Management Office will conduct required computer training. This training will be at no cost to the Contractor. The COR will schedule this training. The MTF will not reimburse the Contractor for any expenses incurred while undergoing any computer training.

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

1.3.5.1. Weekly Progress Report. Until the HCP is performing duties at the MTF and any other period where a replacement HCP is required, the Contractor shall provide to the KO and the COR, on a weekly basis, a progress report indicating the candidate’s name, date identified by the Contractor, date the résumé was submitted to the Government for review, date the credentials package was submitted to the Government, date the MTF privileged the provider, and the targeted start date.

1.3.6. Safety. The Contractor shall ensure that its HCPs comply with all installation safety regulations. Such regulations include, but are not limited to, general safety, fire prevention, and waste disposal. Copies of these regulations are on file in the medical activity safety office or may be obtained through the COR.

1.3.7. Security.

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

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

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

1.3.7.4. Safeguarding Material. The Contractor shall be responsible for safeguarding all Government property provided for Contractor use. The Contractor shall safeguard information of a confidential or sensitive nature. Neither the Contractor nor any of its HCPs shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the likelihood of the possibility of breach of security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974. However, the Contractor may be required to provide testimony or deposition in lawsuits or other administrative, civil, or criminal proceedings.

1.3.7.5. Antiterrorism/Operations Security (AT/OPSEC) Requirements.

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

1.3.7.5.2. Access and general protection/security policy and procedures. This standard language is for contractor employees with an area of performance within Army controlled installation, facility, or area. Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

1.3.7.5.3. For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management.

1.3.7.5.4. iWATCH Training. This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 60 calendar days of contract award and within 60 calendar days of new employees commencing performance with the results reported to the COR NLT 65 calendar days after contract award.

1.3.7.5.5. For contracts that require OPSEC Training. Per AR 530-1 Operations Security, the contractor employees must complete Level I OPSEC Awareness training. New employees must be trained within 30 calendar days of their reporting for duty and annually thereafter.

1.3.7.5.6. For information assurance (IA)/information technology (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of appointment to IA/IT functions.

1.3.7.5.7. For information assurance (IA)/information technology (IT) certification. Per DoD 8570.01-M , DFARS 252.239.7001 and AR 25-2, the contractor employees supporting IA/IT functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M must be completed upon contract award.

1.3.8. Data Breach Response and Notification:

1.3.8.1. The Contractor shall adhere to the reporting and response requirements for PII set forth in Memorandum, Office of the Secretary of Defense, Subject: Safeguarding Against and Responding to the Breach of Personally Identifiable Information (PII), June 5, 2009, ALARACT 050/2009, DoD 5400.11-R, and any amendments.

1.3.8.2. The contractor or its subcontractor shall immediately notify (insert requiring activity and phone number or email address) upon discovery that a suspected or actual breach of PII has occurred. The notification shall include, to the greatest extent possible, the identification of each individual who’s PII has been or possibly has been breached. In addition, the contractor or its subcontractor shall provide (insert requiring activity and phone number or email address) with any other available information that must be included in required breach reporting and notifications. The contractor shall provide this information at the time of the initial notification to the Government or promptly thereafter as information becomes available.

1.3.8.3. The Government will determine whether a breach of PII has occurred, and whether breach notification to affected individuals is required. If breach notification to affected individuals is required, the Government will determine if the contractor shall make the required notification. If the contractor is to notify the impacted population, it shall submit the notification letters to (insert requiring activity and phone number or email address) for review and approval.

1.3.9. Health. The Contractor shall ensure that all HCPs performing services under this contract comply with the health and immunization requirements as stated in the Additional Instructions section "Health and Immunization Requirements" in this contract at the time of initial request for clinical privileges and annually thereafter. The Contractor shall provide equally current certification of health for backup/replacement HCPs at the time of initial request for clinical privileges, and annually thereafter. The expense for all physical examinations to comply with the health requirements shall be borne by the Contractor at no additional cost to the Government.

1.3.10. Contracting Officer’s Representative (COR). The COR will be appointed in writing by the KO after the contract is awarded. The KO will provide a copy of this designation and COR contact information to the Contractor.

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

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

1.4. Hours of Performance.

1.4.1. The duty schedules will be such as to accommodate ambulance unit(s) at William Beaumont Army Medical Center, ambulance unit(s) at East Ft. Bliss per shift, coverage will be 24 hours per day, 7 days per week, 365 days per year.

1.4.2. Contractor personnel shall be able to provide 24 hours a day, 7 day week coverage, not exceeding 80 hours in a two week period. Comp time is not authorized. The Contractor shall maintain a 95% fill rate (defined as shifts worked/available shifts to work) during in a 12-month period of performance.

1.4.3. Breaks. A 60 minute unpaid meal break will be included with each shift. Lunch breaks will be taken at the approximate midpoint of the shift, and will not be saved in order to leave 60 minutes early. Unpaid rest periods, not to exceed 15 minutes every four hours of scheduled duty, if not on a call at that time. Rest periods will not be used for a continuation of lunch/dinner period or taken at the beginning or end of the workday.

1.4.5. Hours worked do not include travel time to reach the military treatment facility (MTF) or other place of performance.

1.4.6. 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.

1.4.7. Organizational Activities. During organizational activities the clinic/facility may close for normal operations and Contractor services may not be required. The Contract employees are not authorized to participate in accordance with MEDCOM regulation 715-3, paragraph 9.n., except during authorized meal times or if a specific waiver is granted by the Commander, MEDCOM. The Government will only pay for work actually performed.

1.5. Conduct.

1.5.1. The Contractor shall ensure that each HCP records the time worked according to procedures determined by the MTF to include documenting hours in DMHRSi.

1.5.2. The Department Chief where services are being performed, or his/her representative, will define the scope of practice. The Contractor shall ensure that its HCPs do not introduce new procedures or services without prior approval of the Department Chief or representative. In disagreements or deviations from established or new protocols, the Department Chief, or representative, will be the deciding authority.

1.5.3. The Contractor shall ensure that its HCPs comply with MTF policies regarding personal appearance and conduct.

1.5.4. The Contractor shall ensure that its HCPs abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the HCP as may be necessary for security and personnel reliability programs. The Contractor shall also ensure that its HCPs abide by federal 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 & Accountability Act of 1996. All regulations referenced are available for review from the COR or MTF. All medical records and reports are and will remain the property of the Government.

1.5.5. Contractor shall abide by all MTF policies, rules and ARs. All personnel shall maintain and support the standards necessary to meet JC and CMS (Centers for Medicare and Medicaid Services) certification. When commencing work under this contract, Contractor shall obtain an in-processing checklist from the COR and provide the COR a copy when completed. The Contractor shall wear an MTF identification badge. The COR/ACOR will assist the Contractor in obtaining the identification badge through the MTF S2/S3 Division-Security Officer. Upon termination of work at this MTF, Contractor is required to return the hospital identification badge and out-process through the activities identified on the out-processing checklist obtained from the COR.

1.5.6. The Contractor shall ensure that its HCPs abide by MTF bylaws, the Joint Commission (JC), DoD and Medical Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in-service training, maintenance of records, performance evaluation, and release of medical information.

1.5.7. The Contractor shall ensure that its HCPs make use of all appropriate equipment, supplies, and services made available by the Government and shall ensure that its HCPs make referrals and seek consultations, as deemed necessary, for the optimal care of the patients.

1.5.8. Removal of HCPs.

1.5.8.1. Removal of HCPs. At any time during the performance of this contract, the Contracting Officer or COR may direct the Contractor to immediately remove any HCP whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other HCPs, Government personnel or to the impaired individual. 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.

1.5.8.2. If the need for a removal occurs, the COR will contact the Contractor's point of contact and direct the Contractor to remove that individual from the military facility and to not use that individual to perform any healthcare services required under this contract until the issue has been resolved by the Contracting Officer. The Contractor shall formally meet with the COR to discuss further action in accordance with the MTF Quality Assurance and Inspection (QA&I) Plan and AR 40-68. A review of the basis for removal will be made by the Contracting Officer within three working days after the COR directed the removal.

1.5.8.3. If, after any investigation deemed necessary by the Contracting Officer and discussions with the Contractor's representative, the Contracting Officer concludes that the HCP’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 HCPs, 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 HCP in accordance with the terms and conditions of this contract.

1.5.8.4. The Commander has the prerogative to hold in abeyance, to deny, or to summarily suspend clinical privileges/practice when there is a reasonable cause to doubt the health care provider’s competence to practice or for any cause affecting the safety of patients or others. AR 40-68 outlines the adverse clinical privileging and practice actions for privileged personnel and adverse practice actions and peer review for non-privileged personnel.

1.5.9. Inquiries. Contractor shall ensure that its personnel do not respond to any media inquiries. Any inquiries from the media shall be immediately relayed to the COR, who will relay them to the MTF Commander. 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 HCP’s Government supervisor.

1.5.10. Smoking. The Contractor shall ensure that its HCPs comply with the MTF smoking policy.

1.5.11. Complaints. Complaints will be validated by the Contracting Officer’s Representative and reported in writing to the Contracting Officer and to the Contractor for action, if it constitutes a failure to perform, as determined by the Government. Patients may also be a source of legitimate complaints that constitute a failure to perform. The contract provider shall have no more than two substantiated complaints per 12-month period per HCP. Any patient complaints received on services provided by the HCP will be taken very seriously at the MTF and as such will be considered a part of the inspection process. The Department Chief will submit documentation to the COR regarding all patient and/or clinical complaints. Receipt of two valid complaints on the HCP within any twelve-month period may be considered grounds for immediate removal.

1.6. Conflict of Interest.

1.6.1. The Contractor/HCP shall not bill the patient for services rendered under this contract. The Contractor/HCP shall be prohibited from receiving 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.

1.6.2. The Contractor or HCP shall not, while performing services under this contract, advice, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the Contractor or HCP at any place other than as designated under this contract and shall ensure that its HCPs do not do so.

1.6.3. The Contractor’s HCPs are not prohibited by reason of their employment under this contract from conducting private practice provided there is no conflict with the performance of services under this contract, subject to any agreement between the Contractor and its employees. The Contracting Officer will unilaterally resolve any issues concerning potential conflicts pertaining to the performance of this contract, not including disputes solely (as determined by the Contracting Officer) between the Contractor and its employees.

1.6.4. The Contractor shall not use Government facilities or other Government property in connection with conducting a private practice and shall ensure that its employees do not do so.

1.6.5. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which are 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 work under this contract. The Contractor shall not release any of the above information without prior written consent of the Contracting Officer and shall ensure that its employees do not do so. The Contractor shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication and shall ensure that its employees do not do so.

1.7. License and Credentials Review or Privileging.

NOTE: Contractor Personnel under any resulting contract are not required to be credentialed at WBAMC.

1.8. Professional Liability.

1.8.1. Pursuant to 10 USC 1089(a), DoD shall process any personal injury claim alleging negligence by the HCP within the scope of the HCP’s performance under this contract as claims alleging negligence by DoD military or civil service HCP. The Contractor or HCP is not required to maintain medical malpractice liability insurance, and the Government will not reimburse or otherwise pay for such insurance should any be purchased

1.8.2. Responsibility and Procedures.

1.8.2.1. If any suit or action is filed or any claim is made against the HCP, which occurred as a result of work performed by the HCP under this contract, the HCP shall immediately notify the Contractor, the Contracting Officer and the Department Chief of the appropriate services and promptly furnish them copies of all pertinent documents received.

1.8.2.2. The Contractor and HCP shall cooperate with the Government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim; and authorize Government representatives to settle or defend the claim and to represent the HCP in, or take charge of, any litigation involved in such an action. The HCP may, at the HCP’s own expense, participate in defense of such claim or litigation.

1.9. Quality Management.

1.9.1. Quality Control Plan (QC): The Contractor is required to follow the current QC program in place at the MTF to ensure that the medical services are provided at a level of quality that meets MTF standards.

1.9.2. Quality Assessment and Improvement (QA&I). The Government will monitor the Contractor's performance under this contract using the QA&I procedures established by the medical activity and pursuant to the Contract Terms and Conditions-Commercial Items clause, paragraph entitled Inspection/Acceptance. Additionally, the Contractor's performance is subject to scheduled and unscheduled review by the QA&I Committee as defined by the medical activity Quality Assurance (QA) Plan and AR 40-68.

1.10. Contractor Representation.

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

1.10.2. The Contractor's representative shall, at no additional cost, meet with the COR when requested by the COR to discuss any problems that the Contractor's personnel may be experiencing during the performance of this contract. Problems experienced by the Government with the Contractor's performance will be discussed and resolved. Unresolved problems will be referred to the Contracting Officer for resolution.

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

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

1.10.5. The contractor shall comply with OTSG/MEDCOM Policy Memo 13-062, Policy for Reporting Incidents of Sexual Assault and Sexual Harassment under the Sexual Assault Prevention and Response Program (SHARP), 12 Nov 2013. The SHARP reporting requirements apply only to knowledge obtained by contractor personnel while performing services under this contract.

1.10.6.. The contractor shall require all Contract Service Providers (CSP) with knowledge of an incident of sexual assault occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

1.10.7. The contractor shall require all CSPs with knowledge of an incident of sexual harassment occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

2. DEFINITIONS/ACRONYMS.

2.1. Definitions. Following is a list of basic definitions.

2.1.1. Ancillary Personnel. This includes all HCPs with the exception of Medical Doctors (MD) and Doctors of Osteopathy (DO).

2.1.2. Armed Forces Health Longitudinal Technology Application (AHLTA). This 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. Backup Personnel. Pre-approved HCPs designated to move into the position of the primary HCP to perform required services for the duration of his/her absence.

2.1.4. Beneficiaries of The Military Healthcare System. Those individuals entitled to care at the MTF in accordance with AR 40-3.

2.1.5. Clinical Privileges. Authorization by the Government to provide specific patient care and treatment services in the organization, within well defined limits, based on the individual's license, education, training, experience, competence, judgment and physical and mental health.

2.1.6. Composite Healthcare System (CHCS). An automated medical information system which will provide integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.

2.1.7. Contracting Officer (KO). A person with the authority to enter into, administer, and/or terminate contracts/task orders and make related determinations and findings.

2.1.8. Contracting Officer’s Representative (COR). A Government employee selected and designated in writing by the KO to act as his/her designated representative in administering a contract. A COR has no authority to change or modify the terms of a contract.

2.1.9. DMHRSi. Defense Medical Human Resource System-Internet. A system that allows time keeping for all employees.

2.1.10 Fill Rate. Ratio of hours (or shifts, as specified in the CLIN) ordered divided by hours (or shifts) worked. Scheduled absences authorized per contract terms are excluded from fill rate calculations.

2.1.11. Military Time is on a 24-hour clock, e.g.:

2.1.12. Military Dates are written by placing the day of the month, followed by the first three letters of the month, followed by the last two digits of the year, e.g.:

January 2, 2014 - 2 Jan 14 January 10, 2014 -10 Jan 14

2.1.13. Physician. Medical HCPs possessing a doctorate degree as a Medical Doctor (MD) or Doctor of Osteopathy (DO).

2.1.14. Privileging Process. Process established by the MTF and AR 40-68 for granting clinical privileges to HCPs.

2.1.15. Quality Assessment and Improvement. Those actions taken by the Government to check services to determine if they meet the requirements of the Joint Commission, U.S. Army Medical Command, quality assurance and risk management program, and ensure that the Contractor and its HCPs comply with the terms and conditions of the contract.

2.1.16. Quality Control. Those actions taken by a Contractor to control the performance of services to ensure that they meet the requirements of the contract.

2.1.17. Replacement Personnel. HCPs selected to fill a position for the duration of the contract period that was previously occupied by another HCP.

2.1.18. TRICARE. A regionalized, tri-service, Contractor-supported, DoD-managed healthcare system.

2.2. Acronyms/Abbreviations. Following is a list of basic acronyms/abbreviations used in this contract.