SRCSGT | Q | FAMILY MEDICINE PHYSICIAN (6 months)

FBO DAILY ISSUE OF MAY 06, 2011 FBO #3450
SOURCES SOUGHT

Q -- FAMILY MEDICINE PHYSICIAN (6 months)

Notice Date: 5/4/2011
Notice Type: Sources Sought
NAICS: 621111 — Offices of Physicians (except Mental Health Specialists)
Contracting Office: Department of the Air Force, Pacific Air Forces, 374 CONS - Yokota, Unit 5228, Yokota AB, APO Japan, 96328-5228
ZIP Code: 96328-5228
Solicitation Number: FA5209PHYSICIAN
Point of Contact: Matthew T. Mancill, Phone: 81-42-551-6735, Andrew Peterson, Phone: 315-225-5553
E-Mail Address: matthew.mancill@yokota.af.mil, andrew.peterson@yokota.af.mil
(matthew.mancill@yokota.af.mil, andrew.peterson@yokota.af.mil)
Small Business Set-Aside: N/A
Description: ((This requirement is for 6 months of service.))) PERFORMANCE-BASED WORK STATEMENT FOR FAMILY MEDICINE PHYSICIAN FOR 374TH MEDICAL GROUP, YOKOTA AIR BASE, JAPAN &emsp; PHYSICIAN CONTRACT AT 374TH MEDICAL GROUP YOKOTA AIR BASE, JAPAN 1. DESCRIPTION OF SERVICES/GENERAL INFORMATION: This is non-personal health care services contract, as defined in FAR 37.101, under which the contractor is an independent contractor. The Contractor shall provide one (1) Family Medicine Physician to provide services required for Government beneficiaries. The Contractor shall provide care at the 374th Medical Group, Yokota AB, Japan, also referred to as the "medical treatment facility" (MTF) herein. The Contractor care shall cover the range of services provided in a civilian medical treatment facility. Performance shall be according to the requirements contained in this performance based work statement (PWS), professional standards of the Joint Commission (JC), and Health Services Inspection (HSI). 1.1. SPECIFIC TASKS: 1.1.1. Training. Training in template management, medical records and database management, CHCS/AHLTA, customer service/conflict resolutions, MEPRS, ICD-9/CPT/ADM coding is desirable. Training will be done on military specific needs to include but not limited to Medical Evaluation Board (MEB) reviews; Profiling; Clearance for a variety of special duties; Occupational and Preventive Health Assessments; and Personal Reliability Program requirements. These activities will be a daily part of medical care for active duty military to maintain a ready force. 1.1.1.1. Initial MTF specific training will occur during Orientation IAW para 1. 2.15.1 of this PWS. Additional training may be required as guidelines change. 1.1.2. Personnel/Support Staff. 1.1.2.1. Utilized and guided by the MTF formulary and prescribing policies and regulations. Drugs not listed on the formulary or specific physician and physician assistant prescribing lists shall be approved by the Pharmacy and Therapeutics Committee prior to routine use or may be special ordered by calling the pharmacist. 1.1.2.2. Preceptor for physician assistant(s), depending on the needs of the clinic and the number of physicians present for duty. 1.1.2.3. Diagnose and treat diseases. 1.1.2.4. Provide consultation in complex cases. Prepare and review case histories and clinical records. Perform and direct diagnostic procedures, including x-ray examinations and clinical laboratory tests. Interpret test results and evaluate examination findings. 1.1.2.5. Prescribe such treatment for acute diseases as drugs, physical therapy and dietary regimens. 1.1.3. Leadership Skills. 1.1.3.1. Support the principles of Population Health and the approach to delivering care. 1.1.3.2. Collaborate with Primary Care Managers (PCM), Health and Wellness Center (HAWC), Health Care Integrator (HCI) and Group Practice Manager (GPM) and other departments for program planning, development, and evaluation in support of the MTF Strategic Plan, Mission Support Plan, and Population Health Plan. 1.1.3.3. Develop interdisciplinary management style through effective communication and collaboration with appropriate departments and team members. 1.1.3.4. Collaborate with all clinic personnel and appropriate departments on matters relating to case management, discharge planning, preventive practices, and utilization management. 1.1.3.5. Delegate tasks to appropriate level and directs support staff in meeting clinic operational requirements. 1.1.4. Professional Qualities. 1.1.4.1. Participate in professional development activities and maintain professional affiliations. Attend conferences and workshops related to duties. 1.1.4.2. Maintain current knowledge of disease management, preventive screening standards and requirements, and current trends in population-based health management. 1.1.4.3. Actively participate in ongoing improvement projects associated with disease management, prevention, and population-based health management. 1.1.4.4. Maintain current knowledge of practice standards and facilitate compliance. 1.1.5. Organizational Skills. 1.1.5.1. Provide input to educate caregivers and patients on prevention and disease management programs. 1.1.5.2. Partner with facility level population health facilitator, HCI or PCM clinic to re-assess and refine clinic level prevention programs. Assist with implementation of new or changing prevention recommendations for the clinic team. 1.1.5.3. Identify barriers to prevention and population health implementation. Coordinate with primary care team to resolve problems and improve processes. 1.1.5.4. Monitor resource consumption via appointment utilization data (appointment types and reason for visit). Perform utilization management activities to optimize cost, quality, and access to care. 1.1.5.5. Collaborate with the HCI in establishing priorities for managing clinic population's health through risk identification, management of acute conditions, and delivery of emergency services. 1.1.5.6. Partner with appropriate departments to assess and select suitable community health services for patient referrals. Coordinate with internal and external agencies to conduct follow-up patient care. 1.1.6. Judgment and Decisions. 1.1.6.1. Educate and counsel patients and families about their potential risk for diseases or injuries. Make appropriate recommendations and referrals. 1.1.6.2. Access information systems to perform peer chart reviews in order to monitor standards of care. Assist quality office if any standard of care reviews need to be performed on peers. 1.1.6.3. Triage questions regarding medical necessity, appropriateness of care, and quality concerns for patients using established guidelines. 1.1.6.4. Assist in telephone calls and consults management. Evaluate patient needs and respond to identified needs and/or redirect concerns to appropriate level of care. 1.1.6.5. Coordinate with appropriate individuals and/or departments regarding delays in service that may impact quality patient care. 1.1.7. Communication Skills. 1.1.7.1. Demonstrate strong customer service skills and foster development of those skills throughout entire PCM team. 1.1.7.2. Communicate and collaborate with the PCM and appropriate members of the health care team to ensure that needs of assigned patients are met without duplication of effort. 1.1.7.3. Network with social services, Integrated Delivery System (IDS), utilization management, and HCI to coordinate actions providing the right care at the right time and the right place. Recognize limitations on interventions imposed by MTF capabilities, community resources, local TRICARE contracts, and remain within scope of authority. 1.1.7.4. Establish liaisons with case managers. Coordinate services through the continuum of care for complex patients. 1.1.8. Procedure Guidance. The Contractor shall furnish procedures compatible with the medical facility's operating capacity and equipment. New medical procedures/services shall not be introduced without prior recommendation to, and approval of, the MTF Commander or authorized representative. 1.2. GENERAL INFORMATION 1.2.1. Personnel Requirements. Applies to all Personnel unless otherwise stated: 1.2.1.1. English Requirement. The physician shall read, understand, speak, and write English well enough to effectively communicate with patients and other Health Care Workers (HCW). 1.2.1.2. Formal Education. The physician must be a graduate of an approved medical school, completed a residency or fellowship acceptable to the U.S. Air Force Surgeon General. 1.2.2. Licensure/Registration. 1.2.2.1. Privileging/Credentials. 1.2.2.1.1. Privileging. The credentials of all providers shall be reviewed and privileges granted as outlined in Air Force Instruction (AFI) 44-119, Chapter 5, Quality Assurance and Risk Management in the Air Force Medical Service. The Contractor is responsible to ensure that proposed staff possesses the requisite credentials enabling the granting of privileges by the MTF. 1.2.2.1.2. Initial applications for clinical privileges, to include credentials action history, malpractice history, and completed copies of the below listed documents, shall be submitted to the MTF Credentials Committee 30 calendar days from receipt of notice of contract award, or when requested by the MTF. Additionally, the Contractor shall make all proposed health care providers available for interview by the MTF during the credentialing process. a. Copy of valid, current, unrestricted state medical license and applicable Board Certification. b. Personnel education and training. c. Current Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certification. d. Current Advanced Pediatric Life Support (PALS) certification e. Current Advance Trauma Life Support (ATLS) certification, or be available to have this completed locally f. Current certification in Neonatal Resuscitation Program (NRP), if applicable. g. A signed consent for release of information. h. Copy of Drug Enforcement Agency (DEA) certificate, if applicable. i. A copy of the proposed contract provider's professional resume, accompanied by that individual's sworn affidavit of the truthfulness of same, indicating experience, training, and technical expertise in the type of care to be rendered. j. A list of all states in which contract healthcare worker currently holds or has held a license to practice related services. k. Completed AF Form 1562, Credentials Evaluation of Health Care Practitioners. 1.2.2.1.3. Applications for privileges will be screened through the National Practitioners Data Bank. 1.2.2.1.4. Professional staff appointments and clinical privilege actions will be based on review of documents in accordance with AFI 44-119. Reappointment shall occur not less than every two years, in accordance with AFI 44-119. 1.2.2.1.5. Applications for clinical privileges for replacement contract providers shall be submitted to the MTF Credentials Committee through the Quality Assurance Personnel (QAP) where services are to be provided not later than 30 calendar days prior to the healthcare worker assuming duty. The credentials requirements are the same as those identified for the primary healthcare worker. 1.2.2.1.6. The Contractor must submit only complete credentials applications for processing. Incomplete applications (those that do not fully comply with the requirements) will not be accepted by the Government and will be returned without action. 1.2.2.1.7. The Contractor must take specific action, including Primary Source Verification, to ensure that contract healthcare worker applications have the required prerequisites for privileging and do not have disqualifying impediments for privileges at the MTF. This is a non-delegable responsibility of the Contractor. 1.2.2.1.8. The Contractor will submit applications for only those contract healthcare workers who can reasonably be anticipated to render the actual, substantial performance on the contract. The submission of primary contract providers for credentialing who lack the requisite qualifications, or who will not work at all, is unacceptable and will be considered a failure to perform. 1.2.2.1.9. Review of Credential Packages. The Government reserves the right to determine if individuals are qualified to perform duties. The MTF reserves the right to refuse an employee based on non-compliance with requirements. This will include review of resumes and can include interviews with prospective contract healthcare workers. 1.2.2.1.10. The physician must maintain an active license/registration during the course of this contract. Employee is responsible for maintaining/renewing licensure. 1.2.2.1.11. Copies of required licensure/certification shall be furnished to the Contracting Officer prior to performance on this contract. 1.2.3. Experience. Two (2) years of Post-graduate Family Medicine outpatient care, Urgent Care or Emergency Medicine experience is preferred. 1.2.4. Identification. All contract personnel shall be clearly identifiable while on duty. All contract personnel shall wear a Contractor or 374 Medical Group (MDG) nametag with the company name, individual's name, and specialty displayed: The nametag shall be worn on the outermost garment. Facility badges must be worn at all times. 1.2.5. Appearance. While on duty, contract personnel shall be neat and clean, well-groomed, and dressed appropriately. Contract personnel's clothing shall fit correctly to provide a professional, modest appearance in keeping with the normally accepted community standards of dress for the work being performed. In all cases, clothing shall be neat and clean. This includes being free from visible dirt and stains. 1.2.6. US Government or Mater Labor Contract Employees. The Contractor shall not hire employees of the U.S. Government and/or Master Labor Contract employees in violation of the Procurement Integrity Act. See FAR Section 3.104. Further, the Contractor shall not employ any Department of Defense employee, either military or civilian, unless such person seeks and receives approval in accordance with Department of Defense 5500.7-R, Joint Ethics Regulation. 1.2.7. Health Requirements. 1.2.7.1. Certification of current physical examination for each employee. The certification shall contain a signed statement by the examining physician stating that the employee is free of any contagious diseases. Physical examination must be current within 12 months prior to application for privileges. Initial documentation is required for: MMR (immunization or titer levels for Rubella and Rubeola), history of chicken pox disease or positive titer (varicella vaccination must be accomplished if lack of immunity), Tetanus Diphtheria (Td), TB Mantoux skin test (IPPD) if positive, minimum requirement will be follow-up with the Contractor's physician and a chest x-ray. A physician must provide documentation of "no active respiratory disease." It is the contractor's responsibility to pay for any medical examinations necessary to ensure this public health compliance requirement is met. 1.2.7.2. Contract personnel providing services under this contract shall receive a pre-employment physical examination prior to commencement of work and annually thereafter. Contract personnel report to a medically-qualified physician to receive a pre-employment examination and immunizations/shots prescribed by the MTF. The request for physical examination will be made using USFJ Form 10 to verify the credibility of the physician being called on to perform this action before services are rendered. It is the contractor's responsibility to pay for any medical examinations necessary to ensure this public health compliance requirement is met. 1.2.7.3. Not later than five (5) working days prior to commencement of work, certification shall be provided to the QAP that contract physician has completed medical evaluation required above. This certification shall state the date on which the examination was completed, the doctor's name that performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: "(name of contract employee) is free from contagious diseases." 1.2.7.4. Also, as a condition of employment, OSHA requires that all contract personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Personnel who sign declinations may change their minds at anytime and receive the Hepatitis B vaccine without penalty. It is the contractor's responsibility to pay for any potential medical examinations necessary to ensure this public health compliance requirement is met. 1.2.7.5. It is the Contractor's responsibility to report to the QAP all information necessary to ensure their employees MTF training and medical records are maintained correctly, and therefore comply with JC, OSHA, and Center for Disease Control health records requirements. 1.2.7.6. Preventive, Prophylactic and Follow-up Procedures. The contractor shall ensure that his/her employees are in compliance with preventive, prophylactic and follow-up procedures, as well as infection control and employee health program procedures, as established by the MTF. Required preventive, prophylactic and follow-up procedures will be provided by the Government to contract employees in the military MTF. The Contractor shall reimburse payment for these services. If care is received elsewhere, the Contractor shall provide written verification of treatment. 1.2.7.7. Pregnant Employees. It is the responsibility of the contractor to notify the QAP of an employee. MTF Employee Health Office will provide information concerning any work hazards in that area. The contractor is to notify their pregnant employee of any work hazards. It will be the employee and the contractor's joint decision whether the contracted employee works in the environment. 1.2.8. HIPAA Compliance. The Contractor agrees to abide by all the requirements of the Health Insurance Portability and Accountability Act (HIPAA) 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 Contractor shall also comply with the Business Associate Agreement listed in the appendix under Privacy of Protected Health Information and hereby incorporated into this performance-base work statement. 1.2.9. Point of Contact. The Contractor shall provide a point of contact who shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The point of contact may be a healthcare worker providing care in accordance with this PWS. The Contractor shall designate this individual, in writing, to the Contracting Officer 30 calendar days before the contract start date. 1.2.9.1. Work Roster. The point of contact shall provide a list by name, start date and social security number of individual personnel the Contractor shall use to provide services. This list shall be provided to the QAP forty-five (45) calendar days in advance to prepare personnel templates and schedules which are made available thirty (30) calendar days out. The Contractor shall submit changes in writing to the QAP at least fifteen (15) calendar days in advance of the proposed change. 1.2.10. Availability. The contract employee shall work an averaged minimum of 40 hours per week, unless specified by the MTF. Duty hours may consist of twelve hour shifts, usually 0700 - 1900 or 1900 - 0700, any day of the week as the Urgent care is open 24 hours per day, every day of the year. Policy regarding daily lunch breaks and other breaks will follow the government's standard procedures for contract personnel. The contract personnel should follow command announcements for reporting to work as it relates to inclement weather or base closures. In the event of real world disasters, all personnel are required to respond to the MTF within 30 minutes and will work until released by their Element Leader. 1.2.10.1. Section Flexibility. Contract personnel may be required to work in other MTF duty sections. Contract personnel shall be flexible in rotating, temporarily moving into other duty sections upon notification of the QAP. All contract support personnel must be cross-trained and oriented into all appropriate Primary Care Departments, including Urgent Care, to maximize activity during peak patient demands. Contract personnel identified for rotation or temporary move into a new duty section will be required to undergo orientation to new section IAW Para. 1.10 of this PWS. 1.2.11. Hours of Operation. Hours of service will be 12 hours per day, a maximum of 15 shifts per month. Any hours worked past the monthly billable hours (beyond 12 hours per day, maximum of 15 shifts per month) are considered overtime, however the overtime hours shall not be paid separately but paid under monthly payment of CLIN 0001 if required, therefore the Contractor shall propose all overtime and monthly task and others into a single CLIN 0001 considering the requirements of this PWS. 1.2.11.1. Federal Holidays. Due to the manning, contract personnel may need to work on Federal Holidays or MTF "Down Days". All UC personnel will be expected to work the same amount of these "special days" averaged over the year. 1.2.12. Arrange for Replacement Staff. The contractor shall have adequate pre-credentialed/pre-privileged replacement healthcare workers available to provide services when health care personnel will be unable to provide services for three (3) or more scheduled shifts. Substitutes shall be as qualified and privileged as the primary HCW. Substitutes are not allowed so the HCW can accept another assignment or to meet the needs of the Contractor. The Contractor must provide a list of replacement healthcare workers at the start of the contract and update whenever personnel change. Replacement is not allowed for the convenience of the Contractor or healthcare worker. 1.2.12.1. Continuity of Services. If routine services are disrupted for more than three (3) consecutive scheduled shifts, the Government reserves the right to procure such services from another source, until routine healthcare worker services are restored by the Contractor. When the Government exercises its right to procure these services from another source, the Government will reduce the Contractor's invoice at an equivalent amount to that incurred. A copy of the other source's service ticket will be used as the basis for this reduction. The Government will furnish the Contractor a copy of this ticket upon the Contractor's request. 1.2.13. Other Requirements. 1.2.13.1. Security Requirements. 1.2.13.1.1. The Contractor Manager or alternate shall complete a Request for Identification Credential (AFMC Form 496) for each employee of the contractor requiring access to Yokota Air Base. The request shall be submitted to Pass and Registration. The Government shall provide a completed Identification Credential (AFMC Form 3876), which shall be issued, displayed and surrendered as directed in AFI 31-209, The Air Force Resource Protection Program. 1.2.13.1.2. Computer Security. A National Agency Check must occur for clearance for appropriate security of privacy act information. Contractor is responsible for completing SF85P Worksheet and providing fingerprint cards for each employee immediately with the hiring process, complying with regulations, DoD 5200.2-R, Appendix K, and AFSSSI 5027, Section 1.8.1.2.1. The above information must be completed and submitted to the MTF prior to personnel starting work. 1.2.13.1.3. Government Computer Access. The contractor will ensure that all contract employees comply with the requirement to obtain the minimum personnel security investigations as prescribed by DoD 5200.2-R and AFI 31-501, paragraphs 3.27.3.7 to 3.27.3.7.2. The contractor will work with the MTF to ensure that the pre-employment screening process for each employee classified as ADP I, II, III (as defined in DoD 5200.2-R) includes the appropriate investigations and that each contract employee has the appropriate questionnaires and forms to be completed. All completed forms will be reviewed by the contractor and forwarded to the MTF for processing prior to the employee beginning work. The contractor understands that, while the MTF Commander may allow contractor personnel to temporarily occupy non-critical sensitive positions pending National Agency Check (NAC), the employee will be immediately removed from the position if at any time the NAC receives unfavorable adjudication, or if other unfavorable information that would affect the NAC becomes known. This must be completed prior to the start of heath care delivery. 1.2.13.2. Criminal Background Check Requirement (MANDATORY). 1.2.13.2.1. The contractor shall ensure that, as a condition of employment, the contractor personnel providing patient care services under this contract meet the requirements of the Crime Control Act of 1990, as amended. This will be accomplished by successfully completing a Criminal Background Check consisting of a Federal Bureau of Investigation (FBI) fingerprint check and State Criminal History Repository check. The procedures for completing the required background checks are outlined within Department of Defense Regulation 5200.1, The DoD Information Security Program and DoD Instruction 1402.5, Criminal History Background Checks on Individuals in Child Care Services, 19 Jan 93. DoDI 1402.5 is available on the internet at: http://web7.whs.osd.mil. 1.2.13.2.2. Personnel may be employed under the contract pending completion of background checks provided the activity uses line-of-site supervision while minor children are in the care of that individual. The contractor provider shall be within line-of-site supervision of either military health care professionals, or an individual who has received an approved background check, or is in the presence of the child's parent or guardian. 1.2.13.2.3. All background investigation requests shall be submitted IAW the applicable directive of the specific medical treatment facility. The name of the Element Leader shall be included in each request as the recipient of the results. 1.2.13.2.4. Individuals shall have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report. 1.2.13.2.5. Individuals who have previously received a background check shall provide proof of the check to the Chief, of the Medical Staff/Medical Services or obtain a new one. A new investigation is required if a break in service to the Department of Defense results in a time lapse of more than 2 years. 1.2.13.2.6. It is the contractor's responsibility to submit background investigation applications to the US Office of Personnel Management for personnel who require them. Payment for the conduct of any criminal history background checks is the responsibility of the contractor. The contractor will provide verifications of submission or completion of the appropriate background investigation, on company letterhead. The verification document will include the following data on the applicant: Name (Last, First, Middle) Date of Birth Place of Birth SSN OPN Case # 1.2.13.2.7. National Agency Check. The contractor shall submit the National Agency Check (NAC) to the US Office of Personnel Management. Applications will include the SF-85P (Application for Public Trust Position), OPM Agency Use Form, and one SF-87/FD258 (Fingerprint Card). Any person who receives an unfavorable NAC or is determined disloyal, untrustworthy, or unreliable, shall be removed from employment by the contractor. 1.2.14. Emergency Health Care. The MTF will provide emergency health care for contract personnel for injuries occurring while on duty in the MTF. These services will be billed to the Contractor at the current full reimbursement rate. 1.2.15. Medical Quality Assurance/Risk Management (QA/RM). 1.2.15.1. Orientation. The Contractor shall ensure that all contract personnel participate in the MTF orientation, training, and service/clinic specific orientation to include any MTF required computer training, this must occur within 30 days of employment. 1.2.15.1.1. The contractor shall ensure that contract HCWs are knowledgeable of the policies and procedures of their specific place of duty and of the medical activity. The contractor shall ensure contract HCWs receive any staff training required by the MTF as a recondition/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 contract HCW. Training requirements will be the same as other MTF employees, to include other contract employees and civil service employees. Some examples of training are: CHCS/AHLTA patient entry, information awareness, local HIPPA training, etc. 1.2.16. Patient Sensitivity. The contract physician shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. The physician receiving complaints validated by the QAP shall be subject to counseling and, depending on the nature and severity of the complaint, separation from performing services under this contract. 1.2.17. Communication. The Contractor shall ensure contract healthcare workers under his/her supervision maintain open and professional communication with members of the MTF. Complaints validated by the QAP and Chief of the Medical Staff, shall be reported in writing to the contract administrator and the Contractor for action. Failure of the Contractor to correct validated complaints raised by the MTF staff and the Contracting Officer will be considered a failure to perform. 1.2.18. Applicable Publication and Forms. The contractor shall comply with Air Force Instruction (AFI) 44-102 and Medical Group Instruction (MDGI) 44-110. These documents are available in the MTF and maintained by the Government. Supplements or amendments to instructions or publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes. The contractor will utilize USFJ Form 10 and DD Form 2161 as referenced in this PWS. 1.2.19. Clinical Evaluations. The contractor shall conduct clinical reviews of all personnel within 60 days of the onset of healthcare delivery. 1.2.20. Indemnification and Medical Liability Insurance.The Contractor shall provide and maintain adequate liability insurance coverage consistent with the risks associated with the performance of all services required by this PWS. Refer to Federal Acquisition Regulation (FAR) Clause 52.237-7, "INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE". 1.2.20.1. Claims Procedures. If any suit or action is filed or any claim is made against the contract health care provider, which occurred as a result of work performed by the health care provider under this contract, the QAP shall: 1.2.20.1.1. Immediately notify the Contracting Officer and promptly furnish copies of all pertinent papers documents. 1.2.20.1.2. The contract health care provider may not be able to perform duties during the processing, review, settlement, or defense of the suit. If that is the case, section 1.2.6. of this PWS would apply. 1.2.21. Denial/Termination of Privileges. a. Actions to limit, suspend, or revoke clinical privileges shall be in accordance with the procedures outlined in AFI 44-119. b. The Contracting Officer and the Contractor shall be notified by the Element Leader as soon as possible when the necessity to exercise such authority becomes apparent. The Element Leader will also provide the Contracting Officer and the Contractor with copies of documentation initiating the revocation process if such actions become apparent. 1.2.22. Customer Complaints. Any customer complaints will be documented on Customer Complaint Record, which may be locally developed method. 1.23.1. Records. If requested by the Government, the Contractor shall provide the original record, or a reproducible copy of any such records within five (5) working days of receipt of the request. 1.2.23. Documentation. All contract personnel shall prepare all documentation to meet or exceed established standards of the MTF to include but not limited to: timeliness, legibility, accuracy, content and signature. Only MTF and Air Force approved abbreviations may be used to document care in the health care record. Contract personnel shall ensure complete patient identifying information is on all documentation that is to become part of a health care record. Contract physicians shall randomly review physician assistants' medical records for quality assurance, accuracy, and compliance with the standard of care. Corrections will be made by the Government or under the direction of the government representative. 1.2.24. Performance of Services during Crisis Declared by the National Command Authority of Oversees Combatant Commander. The Contractor is required to perform essential services in accordance with this PWS in emergency or limited force protection conditions such as natural disaster; however DODI 3020.37 does not apply to this contract for crisis situations where continuation of essential services by the Contractor is unfeasible. 1.2.25. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). 1.2.26. The Contractor is required to ensure that its subcontractor for provisions of health care services, contain the requirements of the clause at FAR52.237-7, including the maintenance of medical liability insurance at minimum $1 million per occurrence, $3 million aggregate. 2. SERVICES SUMMARY (SS). (Revised by P00001) Performance Objectives PWS Para Performance Threshold SS#1. Provide family medicine physician services 1.1.6.1 98% Complete performance of the requirements under the PWS 3. GOVERNMENT FURNISHED PROPERTY/SERVICES The Government will provide the following equipment, supplies, and services listed below: 3.1. OFFICE/WORK/LOCKER AREA. Those areas (office, exam room, etc.,) provided for the use of the contract personnel will present an orderly appearance. Contract personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with accepted community standards. Office space will be shared with other members of the medical team. The government will not be responsible for loss or damage of personal items brought into the MTF. Ensure safe work environment and employee safe work habits, reference MTF and base safety programs. 3.2. EQUIPMENT. The healthcare worker shall have joint use of all available equipment for performing services required by this contract. 3.3. PAGER/CELL PHONE. The MTF will provide a pager or cell phone for use by the contract personnel if required. 3.4. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the contract personnel with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat. 3.5. FORMS. The MTF will provide required Government forms used in the performance of services. 3.6. SUPPLIES. The MTF will provide medical and non-medical supplies commonly used in the facility for the care and management of patients. 3.7. COMPUTER EQUIPMENT. The MTF will provide computer equipment required to schedule, check-in, document, order ancillary services, and maintain appropriate electronic medical information that supports the hard copy medical record. The MTF will provide required training for these systems. The contractor will be required to use the computer systems that are standard for the support of health care delivery at the MTF. 3.8. ADMINISTRATIVE SUPPORT. The contractor personnel will be authorized to use all administrative support available to the government employees. This will include, but is not limited to copy machines, fax machines, installation distribution, Class "A" telephone lines and Defense Switching Network (DSN) lines. The same restrictions to limit use of these items for official government business apply. 3.9. CENTRAL STERILE SUPPLY (CSS). The MTF will supply CSS services. Sterile equipment trays, instrumentation, instrument packs, and supplies will be provided by this service. After use, contract personnel shall follow local procedures and policies to have the government clean and re-sterilize supplies. This service will be available to contract personnel on an equal basis with those of other hospital personnel/services. 3.10. IDENTIFICATION CARDS. The Government will issue a hospital identification (ID) badge which must be worn at all times within the MTF. The ID badge must be visibly displayed between the shirt collar and the waist. A Common Access Card will also be issued to allow the contractor access to necessary computer systems and to the base and the MTF during heightened security. Both cards must be carried by the individual at all times while working at the MTF. 3.11. CONTRACTOR FURNISHED PROPERTY AND SERVICES. Except for those items or services specifically stated in paragraphs 1-11 of this Appendix B to be Government furnished, the Contractor shall furnish everything required to perform this contract in accordance with all of its terms. 4. APPENDICES. A. Clinical Privileges Evaluation Summary B. GFP/Services C. Privacy of Protected Health Information &emsp; APPENDIX A CLINICAL PRIVILEGES EVALUATION SUMMARY (Use additional paper, if necessary, to fully explain any comments) 1. NAME OF PROVIDER 2. SSN 3. MTF 4. Department/Service Family Medicine 5. Period of Evaluation From To 6. Purpose of Evaluation  Renewal Initial Privileges  Reassignment/Separation 7. Activity Data (Provide average monthly data for each item, as applicable) ( )Ambulatory Care Visits ( )Urgent Care Center ( )Admissions ( )Surgical Procedures ( ) Deliveries 8. Is there any aspect of the provider's health status which the credentials function should consider in awarding privileges? NO YES (explain) 9. Is the provider's license and specialty certification current? YES NO (explain) 10. Is the provider's attendance and participation in staff and committee meetings acceptable? YES NO (explain) 11. Are the provider's interpersonal skills with both patients and staff acceptable? YES NO (explain) 12. Appraisal of Privileges (As applicable, explain any patterns of care demonstrated through the following functions) A. Antibiotic usage review Choice of antibiotics appropriate: Antibiotic use clinically valid/warranted: Any prescribing trends identified in DUES: B. Surgical Case Review Case selection appropriate: Colposcopy Vasectomy Skin Biopsy Deviations between pre/post and diagnosis/path: Tissue submitted appropriately: Informed consent obtained and documented: C. Records Review Number of records reviewed______ Practice patterns are safe and appropriate: Comments D. Pharmacy and therapeutics review Deviations identified in DUES: # of therapeutic interventions decreasing: Use of controlled substances appropriate: E. Morbidity/Mortality review # of deaths: _______ # of major complications, standard of care not met: F. Infection Control Follows accepted guidelines: # of nosocomial infections:__ # of wound infections:____ G. Utilization management Uses available resources appropriately: Admissions/discharges follow established guidelines: H. ANCILLARY (Support Services) REVIEW Requests for laboratory and x-ray tests are appropriate: Excessive use of laboratory resources: I. STANDARD OF CARE ISSUES: Trends J. RISK MANAGEMENT Reports cases as appropriate to Risk Manager: # Patient complaints: Claims filed: K. DEPARTMENT/SERVICE SPECIFIC REVIEWS Sectional/Departmental Reviews: Teams: Clinical Practice Guidelines: Special Performance Improvement Projects: 13. REMARKS The following evaluation is based on demonstrated performance compared to that reasonably expected of a practitioner at his or her level of training, experience and background: Performance Poor Fair Good Superior Not Observed A. Basic Professional knowledge B. Professional judgment C. Sense of responsibility D. Ethical conduct E. Competence and skill F. Cooperativeness, ability to work with others G. History and Physical exam H. Record keeping I. Case presentations J. Patient management K. Ability to write and speak English L. Regularly obtained consultations when needed Comments Continuing Education........ Total hours for 200______ through 200_____ = _______________ __________________ % of CME credits taken in specialty DATE GRADE/NAME OF EVALUATOR SIGNATURE OF EVALUATOR EVALUATION REVIEWED BY PROVIDER * YES * NO DEPT/SERVICE/SECTION: PROVIDER REVIEWED: TIME PERIOD INDICATOR: Documentation of care provided in the outpatient setting will be legible and reflect quality care LEGEND: = MET CRITERIA  = DID NOT MEET CRITERIA E = MET APPROVED EXCEPTION N/A = NOT APPLICABLE PATIENT IDENTIFICATION RESULTS Number and List Criteria 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 % OR # 1. Appropriateness and quality of care is apparent by the following: (SOAPE) format. a. Subjective note includes pertinent positive and negative aspects of history. Pt statement of pain, if applicable. Assessment & Mgmt of pain if indicated b. Objective note includes pertinent positive and negative findings. c. Assessment supported by history and physical. d. Plan includes therapy appropriate for diagnosis and plan for follow-up. Pain management included, if applicable. e. Prevention statement made at time of visit f. Education is appropriate for assessment, diagnosis, follow-up, or referral g. Diagnostic tests, medications and procedures were appropriate for diagnosis. 2. Documentation is legible. 3. Duty determination made when indicated: PRP/Flying status/line of duty. 4. Follow-up of abnormal clinical/diagnostic findings has been accomplished if indicated. COMMENTS (Explain exceptions) SIGNATURE OF DATA GATHER: DATE: &emsp; APPENDIX B GOVERNMENT FURNISHED PROPERTY/SERVICES The Government will provide the following equipment, supplies, and services listed below: 1. OFFICE/WORK/LOCKER AREA. Those areas (office, exam room, etc.,) provided for the use of the contract personnel will present an orderly appearance. Contract personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with accepted community standards. Office space will be shared with other members of the medical team. The government will not be responsible for loss or damage of personal items brought into the MTF. Ensure safe work environment and employee safe work habits, reference MTF and base safety programs. 2. EQUIPMENT. The healthcare worker shall have joint use of all available equipment for performing services required by this contract. 3. PAGER/CELL PHONE. The MTF will provide a pager or cell phone for use by the contract personnel if required. 4. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the contract personnel with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat. 5. FORMS. The MTF will provide required Government forms used in the performance of services. 6. SUPPLIES. The MTF will provide medical and non-medical supplies commonly used in the facility for the care and management of patients. 7. COMPUTER EQUIPMENT. The MTF will provide computer equipment required to schedule, check-in, document, order ancillary services, and maintain appropriate electronic medical information that supports the hard copy medical record. The MTF will provide required training for these systems. The contractor will be required to use the computer systems that are standard for the support of health care delivery at the MTF. 8. ADMINISTRATIVE SUPPORT. The contractor personnel will be authorized to use all administrative support available to the government employees. This will include, but is not limited to copy machines, fax machines, installation distribution, Class "A" telephone lines and Defense Switching Network (DSN) lines. The same restrictions to limit use of these items for official government business apply. 9. CENTRAL STERILE SUPPLY (CSS). The MTF will supply CSS services. Sterile equipment trays, instrumentation, instrument packs, and supplies will be provided by this service. After use, contract personnel shall follow local procedures and policies to have the government clean and re-sterilize supplies. 10. IDENTIFICATION CARDS. The Government will issue a hospital identification (ID) badge which must be worn at all times within the MTF. The ID badge must be visibly displayed between the shirt collar and the waist. A Common Access Card will also be issued to allow the contractor access to necessary computer systems and to the base and the MTF during heightened security. Both cards must be carried by the individual at all times while working at the MTF. 11. CONTRACTOR FURNISHED PROPERTY AND SERVICES. Except for those items or services specifically stated in paragraphs 1-11 of this Appendix B to be Government furnished, the Contractor shall furnish everything required to perform this contract in accordance with all of its terms. APPENDIX C 1. PRIVACY OF PROTECTED HEALTH INFORMATION (a) Definitions. As used in this Business Associate Agreement: Individual has the same meaning as the term "individual" in 45 CFR 164.501 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g). Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR Part 160 and Part 164, subparts A and E. Protected Health Information has the same meaning as the term "protected health information" in 45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of The Government. Required by Law has the same meaning as the term "required by law" in 45 CFR 164.501. Secretary means the Secretary of the Department of Health and Human Services or his/her designee. Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103 and 164.501. (b) The Contractor shall not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law. (c) The Contractor shall use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract. (d) The Contractor shall mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract. (e) The Contractor shall report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract. (f) The Contractor shall ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor on behalf of the Government, agrees to the same restrictions and conditions that apply through this Contract to the Contractor with respect to such information. (g) The Contractor shall provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524. (h) The Contractor shall make any amendment(s) to Protected Health Information in a Designated Record Set that the Government directs pursuant to 45 CFR 164.526 at the request of the Government and in the time and manner designated by the Government. (i) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the Government or the Secretary, for purposes of the Secretary determining the Government's compliance with the Privacy Rule. (j) The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528. (k) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Business Associate Agreement of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528. General Use and Disclosure Provisions Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government if such use or disclosure of Protected Health Information would not violate the Privacy Rule or the Department of Defense Health Information Privacy Regulation. Specific Use and Disclosure Provisions (a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor. (b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached. (c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B). (d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j)(1). Obligations of the Government Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions (a) Upon request, the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice. (b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures. (c) The Government shall notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522. Termination (a) Termination. A breach by the Contractor of this Business Associate Agreement, may subject the Contractor to termination under any applicable default or termination provision of this Contract. (b) Effect of Termination. (1) If this contract has records management requirements, the records subject to this Business Associate Agreement should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraph (2) below. (2) If this contract does not have records management requirements, upon termination of this Contract, for any reason, the Contractor shall return documents less than six years old or destroy documents older than six years of all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health Information. Miscellaneous (a) Regulatory References. A reference in this Agreement to a section in the Privacy Rule means the section as in effect or as amended, and for which compliance is required. (b) Survival. The respective rights and obligations of Business Associate under the "Effect of Termination" provision of this Agreement shall survive the termination of this Contract. (c) Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a meaning that permits the Government to comply with the Privacy Rule.
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Place of Performance: Address: Yokota Air Base, Japan, APO, Non-U.S., 96326, Japan
Record: SN02440467-W 20110506/110504235842-cbfb82919dfd95d307b63cf8bd742cbf (fbodaily.com)
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Q -- FAMILY MEDICINE PHYSICIAN (6 months)