PRESOL | Q | This is a requirement for USAFSAM/Hyperbaric Division for a certified hyperbaric registered nurse

FBO DAILY ISSUE OF SEPTEMBER 19, 2010 FBO #3221
SOLICITATION NOTICE

Q -- This is a requirement for USAFSAM/Hyperbaric Division for a certified hyperbaric registered nurse

Notice Date: 9/17/2010
Notice Type: Combined Synopsis/Solicitation
NAICS: 621399 — Offices of All Other Miscellaneous Health Practitioners
Contracting Office: Department of the Air Force, Air Force Materiel Command, ABG - 311 Air Base Group, 8150 Aeromedical Road, Brooks City-Base, Texas, 78235, United States
ZIP Code: 78235
Solicitation Number: FA8900-10-R-0011
Archive Date: 9/27/2010
Point of Contact: Mary N Farr, Phone: 210-536-6212, Veronica A. Romero, Phone: 2105364081
E-Mail Address: mary.farr@brooks.af.mil, Veronica.Romero@brooks.af.mil
(mary.farr@brooks.af.mil, Veronica.Romero@brooks.af.mil)
Small Business Set-Aside: Total Small Business
Description: PERFORMANCE WORK STATEMENT FOR LICENSED REGISTERED NURSE FOR UNITED STATES AIR FORCE SCHOOL OF AEROSPACE MEDICINE HYPERBARIC MEDICINE DIVISION (USAFSAM/FEEH)dated 16 June 2010 TABLE OF CONTENTS 1.0 INTRODUCTION: 2.0 DESCRIPTION OF SERVICES: 3.0 SERVICE SUMMARY (SS): 4.0 GOVERNMENT FURNISHED PROPERTY: 5.0 GENERAL INFORMATION: 6.0 TRAVEL AND OTHER DIRECT COSTS: 7.0 SECURITY REQUIREMENTS: 8.0 REPORTS AND DATA REPORTING REQUIREMENTS: 9.0 CONTINUATION OF ESSENTIAL DOD CONTRACTOR SERVICES DURING CRISIS: 10.0 APPENDICES: 1.0 INTRODUCTION: 1.1 The Contractor shall provide non-personal services for Hyperbaric Registered Nurse (CHRN) referred to as "Contract Personnel" at San Antonio Military Medical Campus- South (SAMMC-S) Hyperbaric Medicine Center, Wilford Hall Medical Center, Texas. Contract personnel shall perform services and support compatible with the medical facility's operating capacity and equipment. 1.2 The CHRN will provide hyperbaric medical and clinical wound care as an integral staff member of the clinic. Performance requirements are contained in this performance of work statement (PWS) and standardized according to current recognized national standards as established by the American Nurses Association, the Joint Commission on Accreditation of Healthcare Organization (JCAHO), the American Heart Association (AHA), the American Red Cross and the Baromedical Nurses Association (BNA). 1.3 The responsibilities of the CHRN are to provide basic and advanced nursing/wound care to the beneficiaries of the Hyperbaric Medicine Branch. The Contract Personnel will assist in the planning, organizing, coordination, supervision and execution of continuing education, in-service education, unit orientation programs and competency verification programs for professional nurse, medical technicians and physiology technicians assigned to the Hyperbaric Medicine Branch. 2.0 DESCRIPTION OF SERVICES 2.1 Specific Tasks. Nursing care will include where appropriate: compiling patient medical history, obtaining vital signs and basic to advanced wound care procedures. Contract personnel will setup, maintain, and operate the following medical equipment: Allaris Medisystem III Intravenous pump, Welch Allyn PROPAQ EKG/vital signs monitor, Omni Vent Series D ventilator, Radiometer TCM400, Welch Allyn Vital Sign monitor, pulse oximeter, portable suction devices, portable specimen centrifuge, Burdick 12 lead EKG machine, Lifepak 20 Automatic Defibrillator, Perimed Laser Doppler unit, ultrasonic instrument washer and steam autoclave. Contract personnel will perform Transcutaneous Oxygen monitoring (TCOM) testing. Perform Ankle Brachial Index (ABI) calculations/testing, intravenous/parenteral therapies, electrocardiograph recordings (EKG), perform digital wound photography and perform Perimed laser doppler studies. Documentation of acquired data will be input into provided forms and automated data systems. Ensure the creation, filing and maintenance of hyperbaric medical record files. The Contract Personnel will submit audit and assessment of identified documentation trends and hyperbaric patient outcomes. The Contract Personnel will coordinate with fellow staff and physicians, ancillary services, and outside agencies to ensure safe, effective, well-planned total patient care. The Contract Personnel will perform general nursing care for up to 24 patients per day. The Contract Personnel will manage patient movement in and out of the hyperbaric chambers and conduct daily patient wound care. The Contract Personnel will have a working knowledge of computer keyboarding and Microsoft Office software. Maintain/provide in-service briefings. Escorts VIP personnel touring the department. Assists the Operations Branch Chief in preparing and maintaining education records. Compiles data for quality assurance reports, audits, certification agencies and other duties as directed by the Operations Branch Chief and/or the Chief, Hyperbaric Medicine Branch. The Contract Personnel will, after unit orientation and six months working experience, assume ancillary administrative jobs such as education and training, training in-service coordinator and medical records auditor. Ancillary program assignments will be at the Branch Directors discretion. The Contract Personnel will be knowledgeable of the mission, regulations, goals, objectives, organization and policies of the Hyperbaric Medicine Branch, US Air Force School of Aerospace Medicine (USAFSAM), and the US Air Force. Contract personnel may perform inside observer duties on an irregular and as required basis to support the hyperbaric operations. 2.2 KNOWLEDGE AND EXPERIENCE: Four years experience in Hyperbaric Medicine and wound care is preferred. The registered nurse must have a current registered nursing license, approved by the state of Texas. Possession of a current CHRN certification per the National Board of Diving and Hyperbaric Medicine is mandatory. Related nursing duties include background knowledge of hyperbaric medicine, the dispensing of medications (to include narcotics), validating narcotic drug inventory, initiating, managing and discontinuing intravenous therapies, performing basic to advanced wound care procedures, basic patient care functions and clinical nursing hyperbaric evaluations. Critical care, emergency department, teaching and management experience are highly desirable. The Contract Personnel will possess current Basic Life Support (BLS) with Automated External Defibrillation (AED) certifications through the American Heart Association or American Red Cross. BLS/AED certification will be maintained during entire length of this contract. Advanced certifications such as Advanced Cardiac Life Support (ACLS), and Trauma Life Support are highly encouraged. 2.3 Health Requirements and Immunizations. All Contractor personnel shall control and prevent disease in accordance with AFI 48-105, Surveillance Prevention and Control of Diseases and Conditions of Public Health or Military Significance, and the American Public Health Association Publication, Control of Communicable Diseases Manual, and the Centers for Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report, Air Force Policy (as applicable) and its supplements. 2.3.1 The Contractor shall provide proof of immunization or immunity from or screening for the following diseases according to Air Force guidelines equivalent to that provided to active duty armed forces: Hepatitis B, MMR (Measles, Mumps, and Rubella), Varicella, Tdap (Tetanus, Diphtheria, and Pertussis), Tuberculosis (TB), HIV (contract personnel who have direct patient care) and influenza (IAW 1.2.8.2.) for all personnel prior to contract performance. For the TB screening, the Contractor shall provide proof of negative TB 2-step skin testing IAW CDC recommendations outlined in attachment one (1) of this document. If an individual has a past positive TB skin test, the Contractor shall provide proof of a negative chest X-ray within twelve (12) months) prior to personnel performing. The Government reserves the right to require more frequent Tuberculosis testing of personnel based on the facilities' annual TB risk assessment. Additional vaccines as they are made mandatory for health care workers may also be required in unusual circumstances. 2.3.2 The Contractor will receive a pre-employment physical examination, equivalent to the Professional Association of Diving Instructions (PADI) recreational diving physical, prior to commencement of work. Clearance must be kept annually thereafter. Physical examinations, forms and payment will be the Contractor's responsibility. Discovery of disqualifying medical conditions which would pose a hazard to the individuals health, safety or compromise patient care in the hyperbaric environment, will constitute sufficient grounds for non-hire, duty not to involve diving (transient condition only, requiring medical clearance for resumption of diving duties), or termination of employment. Concealment of any disqualifying medical condition, regardless of waiver ability, will constitute sufficient ground for immediate termination with prejudice. The Contractor must provide for the pre-employment medical evaluation immunizations as prescribed by the Hyperbaric Medicine Division and the US Air Force. 2.4 Administrative. The contractor will treat any patient lists, no matter how developed, as privileged information. Lists and/or names of patients will not be disclosed to or revealed in any way for any use outside the Hyperbaric Medicine Division without prior written permission by the division's Chief, Hyperbaric Medicine branch or Operations Branch Chief. 2.4.1 The Contract Personnel will respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Receipt of complaints validated by the Contract Monitor and Operations Branch Chief will subject the Contract Personnel to formal counseling or, depending on the nature and severity of the complain, possible separation from performing services under this contract. 2.4.2 The Contract Personnel will release medical information obtained during the course of this contract to other Hyperbaric Medicine Division staff and only to those parties or agencies directly involved in the care and treatment of the individual patient. 2.4.3 The Contractor will ensure that the Contract Personnel maintains open and professional communications with members of the Hyperbaric Medicine Division. Complaints validated by the Contract Monitor and the Operations Branch Chief will be reported in writing to the Contract Officer and the Contractor for action. Failure of the Contractor to correct validated complaints raised by the Hyperbaric Medicine Division staff and the CO will be considered a failure to perform. 2.5 Staffing. The Contractor shall provide qualified and trained contract personnel to cover the required hours of performance. The Contractor shall staff and contract personnel to meet the requirements in this PWS and ensure continuity of performance. If the contract personnel is absent for more than three (3) working days, the Contractor shall initiate replacement action on the fourth day. 2.6 The Contractor shall manage all data created for Government use or legally controlled by the Government, in support of the functional activity or required by AF publication, IAW with the AF records management procedures in Air Force Instruction (AFI) 33 - 322, Records Management Program, paragraph 10, Air Force Manual (AFMAN) 37-123,paragraph 7.4, AFMAN 37-138, paragraph 2.13, and the Air Force Records Disposition Schedule (AF RDS) located at https://afrims.amc.af.mil/rds_series.cfm or http://www.amc.af.mil/shared/media/document/AFD-060803-003.pdf. 2.7 The Contractor shall perform all primary and annual licensure or certification document verifications for the contract personnel to include all replacement contract personnel not requiring credentialing. Verifications shall be submitted in at least ten (10) working days prior to the proposed backup/replacement beginning work in accordance with attachment one (1). 2.8 The Contractor shall confirm that the clinical licenses or certifications have not been suspended or revoked by any healthcare facility, public or private, anywhere in the world. This does not preclude any contract personnel whose licensure or certification, although originally suspended or revoked by a healthcare facility, was subsequently fully reinstated by the same. 2.9 The Contractor shall be able to dead lift 40 pounds. 3.0 SERVICE SUMMARY (SS) Performance Objective PWS Paragraph Performance Threshold Surveillance Method Conduct basic and advanced wound care 2.1 No more than 3 substantiated complaints per month Customer Feedback Conduct in-service hyperbaric-related training 2.1 At least one training session per month Quarterly periodic inspection Submit audit and assessment of identified documentation trends 2.1 Report due by first week of next month Quarterly periodic inspection Submit audit and assessment of hyperbaric patient outcomes 2.1 Report due by first week of next month Quarterly periodic inspection 4.0 GOVERNMENT FURNISHED PROPERTY 4.1 Facilities and Support Services. The Government will provide use of all available MTF facilities and support services, materials, publications and forms, equipment, and specialty clothing required for contract performance (except as designated in the contract). 4.2 The contract personnel shall keep Government furnished supplies, equipment, and work areas in a safe, orderly and clean condition. The contract personnel shall notify hyperbaric supervisory staff whenever maintenance of equipment is required. The contract personnel shall not use Government facilities or other Government property for personal or other business not related to this contract. 4.3 Personal Protective Equipment (PPE). The Government will furnish the contract personnel with appropriate common use PPE (e.g., face shield, gloves, and lead vests). The Government will be responsible for any repair, cleaning, and inventory required for the PPE. 4.4 MTF Orientation. The contract personnel shall attend the MTF Orientation at the outset of their working at MTF. The MTF Orientation will familiarize the contract personnel with the policies and procedures of the MTF and will be scheduled by the QA or designated government representatives within two months of employment. Orientation attendance shall be required of the contract personnel during government-paid duty hours. 4.5 Training. The Government will schedule and furnish initial and annual training to include but are not limited to various applicable software, data base systems, quality assurance policies, radiation safety, local in-service, safety briefings, compliance, patient safety, performance improvement, risk management, infection control, fire protection, security, and patient sensitivity training. The classes may be scheduled individually throughout the year or scheduled at one time. 4.6 Specialty Training. The Government may provide voluntary specialty training to contract personnel in a non-paid status. Training Bulletin NO. 07-003 (7 Feb 07), this training will not be provided by the government. 4.7 Space. Any space used by contract personnel in performance of this contract may be used for other purposes during their absence. Items of clothing, personal effects, or equipment may not be able to be secured at the MTF. The Government will not incur any liability for theft, damage to, or loss of such personal items. 4.8 Telephone. The Government will provide local telephone service, Class-A telephone lines and Defense Switching Network lines limited to matters related to the performance of this contract. Personal long distance calls are not authorized. 4.9 Badges. The government will provide MTF ID badges and will be worn/displayed at all times. 4.10 Pager. When on-call, the contract personnel shall use the communication device (pager) or other electronic device issued by MTF. 4.11 Uniforms. The MTF shall furnish surgical scrubs. These items will be cleaned at the MTF's expense. 5.0 GENERAL INFORMATION 5.1 Contractor Representative. The contractor shall identify the name and local telephone number of the contractor's local point of contact to the CO in writing prior to beginning performance. The contractor shall identify in the designation letter any limitations on its representative's authority to act on behalf of the contractor. The contractor shall provide an updated designation letter whenever any changes occur. The contractor representative may be required to meet with the government during the performance of this contract at the request of the CO. The government reserves the right to verify the hours worked by the Contract Personnel. 5.1.1 The Contractor Representative shall respond to a request to meet with the CO within 24 hours of notification under routine circumstances. Crisis situations shall be handled on a case by case basis as circumstances dictate. 5.2 Hours of Performance. Normal daily hours for all clinics are 6:55a.m.-3:55p.m. The eight hour work day will not include the one hour meal break (traditional lunch break) per workday. The duty week shall not exceed forty (40) hours in five (5) calendar days. The Contractor shall provide full coverage (continuous presence) during the required hours of performance. The Contractor shall maintain personnel continuity to the maximum extent consistent with efficient resource management. 5.3 Family/Down Days. Typically, a "Family Day/Down Day" is associated with, but not limited to, the following holidays: New Year's Day, July 4th, Thanksgiving, and Christmas. The Contractor shall not bill the Government for the Family Day/Down Day unless the contract personnel are required to report to work. The following is a list of legal federal holidays: New Year's Day, January 1st; Martin Luther King's Birthday, 3rd Monday in January; President's, Day, 3rd Monday in February; Memorial Day, last Monday in May; Independence Day, July 4th; Labor Day, 1st Monday I September; Columbus Day, 2nd Monday in October; Veteran's Day, November 11th; Thanksgiving Day, 4th Thursday in November; Christmas Day, December 25th. 5.4 Inclement Weather. In the event of inclement weather (snow, ice, etc.), the government will notify the contractor whether its personnel shall report and, if so, when. The contractor will instruct its personnel scheduled to report for duty (who have not yet begun their shift) whether to report and, if so, when. If the government directs the contractor not to report for any shift, the government will not pay the contractor for that shift or those shifts. 5.4.1 The contractor's personnel on duty at the onset of inclement weather (as declared by local base officials) shall remain on duty until the end of their scheduled shift unless otherwise directed by their employer. 5.4.2 In the event that the contractor's personnel are on duty and cannot leave the installation due to inclement weather (as declared by local base authorities), the contractor will not be allowed to invoice for overtime hours. 5.5 Compliance. The contract personnel shall complete the Initial profile package requirements (attachment on (1). The contract personnel shall comply with all applicable Air Force Instructions (AFI), Department of Defense (DoD) Regulations, and Medical Wing Instructions (MDWI) as outlined in attachment two (2). 5.5.1 Documentation. The contract personnel shall prepare all documentation to meet or exceed established standards as set forth in the most current version of AFI 41-35, "Health Record Documentation". 5.5.2 Medical Tests. The Contractor shall not obtain medical tests or procedures at the MTF unless contract personnel are an allowed beneficiary for such services. 5.5.3 Influenza Immunization. Contractor Personnel shall receive the current influenza immunization, at contractor's expense, equivalent to that provided to active duty armed forces personnel unless contraindicated by allergy; as an example, to eggs as evidenced by hives, difficulty breathing, itching, and other symptoms of anaphylactic hypersensitivity and/or physician's diagnosis. 5.5.4 Vaccine. Influenza vaccine will be provided by the Government, if available as determined by the MTF. Although this vaccine may be provided by the Government, it may be obtained at other facilities with the cost being borne by the Contractor. Unless vaccinated by the Government, proof of vaccination will be required. 5.6 Conduct Requirements. The government reserves the right to restrict the performance on this contract by any individual who is identified as a potential threat to the health, safety, security, general well-being, or operational mission of the MTF and its population. The contract personnel shall not advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such person should receive care at an outside agency or provider at any place other than as designated under this contract. 5.6.1 The contract personnel shall not respond to any media inquiries nor provide interviews, comments, or any other responses to the media. All inquiries or complaints from the media or other sources shall be immediately relayed to the QA or designated government representatives. 5.7 Removal of Contractor Personnel. The government reserves the right to require immediate temporary or permanent removal of any individual whose actions raise reasonable suspicion that patient care or services may be compromised in any way or that pose a threat of harm to other contractor/government personnel or self. Removal of any individual does not relieve the contractor of any performance requirement. 5.8 If a removal occurs, the QA will contact the CO and the contractor's representative within twenty-four (24) hours. A meeting may be required with the CO, QA and Contractor representative to discuss further action. Notification of all removals will be made by the CO. 5.9 Physical Security. Areas accessed by the contract personnel shall comply with base instructions for FPCON procedures, Random Antiterrorism Measures, and local search/identification requirements. 5.10 Internal Operating Instructions. The Contractor/contract personnel shall abide by host unit's current Operating Instructions (OIs) for internal circulation control, protection of resources, and regulated entry into Air Force controlled areas during normal, simulated, and actual emergency operations. 5.11 Keys and Lock Combinations. The contract personnel shall abide by all current MTF key control and lock combination procedures. The Contractor shall be responsible for any keys issued to the contract personnel. The keys shall not be duplicated. The Contractor shall ensure its contract personnel do not allow government-issued keys to be used by personnel other than those currently authorized. No unauthorized personnel shall be allowed entry into the locked area. Keys shall not be used to open work areas for personnel other than personnel engaged in performance of their tasks, unless authorized by the Government functional area chief. The contract personnel shall use keys issued to them to secure/open areas only as directed by the QA and/or functional area chief. Lost keys and/or locks shall be reported to the issuing party and QA immediately upon recognition of the loss. The QA shall notify the CO of the lost key. The contract personnel shall be responsible for the replacement costs of any lost keys and any associated locks. Reimbursement shall be provided before the Government replaces lost keys or performs re-keying. 5.12 The MTF will provide emergency healthcare for injuries occurring while on duty. The Contractor shall reimburse the government for such services. This includes blood borne exposure protocols after start of work. The Government will provide initial testing at no cost, but the Contractor shall provide follow-up testing or reimburse the government for such services performed within the MTF. The Contractor will provide the MTF with documentation for follow-ups performed outside the MTF as required by MTF policy. The Government will provide post-exposure tuberculosis testing at no charge to the Contractor when required (ex. following exposure to active TB case within the MTF) to avoid testing delays. 5.13 Compliance With State And Federal Standards: All work will be accomplished in accordance with applicable federal, state and local regulations including the Office of Safety and Health Administration and the Environmental Protection Agency. Upon arrival at the Hyperbaric Medicine Branch, the Contract Personnel will report to the Operations Branch Chief, Bldg 4550, telephone 292-3483, for orientation instructions 5.14 The period of performance for this task order is 12 months from date of award, and one option year. 6.0 TRAVEL AND OTHER DIRECT COSTS 6.1 The Contract Personnel is responsible for transportation to and from the duty facility. Other travel requirements are unknown at the time of contract award. When other travel is identified, the requirement will be incorporated into this purchase order via a separate bilateral modification. 6.2 Before travel is performed, contractor personnel must obtain approval from the COR. Contractors will employ due diligence in formulating the most economic, efficient, and reasonable travel itinerary (airlines and lodging). 6.3 Within three workdays after conclusion of travel, the Contractor shall provide a report of travel expenses to the COR in Excel format. The report will reflect a running tally of costs for all approved travel and cumulative total. Travel reimbursement(s) will be according to Joint Travel Regulations. 7.0 SECURITY REQUIREMENTS 7.1 Security Training. The contract personnel shall be trained in accordance with AFI 31-501, AFI 31-401; AFI 33-202, Computer Security; AFI 31-101 Installation Security; AFI 33-203, Emission Security (EMSEC) and AFI 33-204, Information Protection Security Awareness, Training, and Education (SATE) Program. 7.2 The Contractor shall notify the 37 SFS Industrial Security Office at each operating location prior to the performance of the contract. The notification shall include the contract number, contracting agency, the date service performance begins and ends, location(s) of service performance and future performance, and the reason for the contract (i.e., work to be performed). 7.3 Obtaining Pass and Identification Items. The Contractor shall ensure that the pass and identification items required for contract performance are obtained for the contract personnel providing service. The Government will provide MTF ID badges which will be displayed while performing tasks in the MTF. 7.4 Investigation Requirements. The contractor providing service under this contract is required to initiate the Electronic Personnel Security Questionnaire (EPSQ), 59th MDW/LS Contracting Services will send a CD and instructions to complete the EPSQ when a contract is awarded. SF85P Questionnaire for Public Trust Positions is to be completed and printed and electronic copies (CD or thumb drive) are to be hand carried to the Unit Security Manager prior to performance. The contractor shall have proof of U.S. citizenship (certified copy of birth certificate or naturalization papers) or a valid U.S. Immigration Form 1-151 and Alien Registration Card ("Green Card"). As a minimum, the contractor providing service requiring operating government-furnished workstations that have access to Air Force e-mail and requiring unescorted entry to a restricted area/Controlled Areas, must successfully complete a National Agency Check (NAC). The contractor shall coordinate and schedule appointments with the MTF Security Manager prior to performance. The unit security manager will initiate the AF FM 2583 Request for Personnel Security Action, review the security questionnaire and request a Local Background Check from 37 SFAR prior to scheduling an appointment with the 37 Security Forces to submit the EPSQ. This security questionnaire must be completed/processed by the 37 SFS Personnel Security Office prior to contract performance. The contractor is responsible for monitoring the coordination and completion of the scheduled appointment date and time with Security Forces. The security questionnaire reviewed by the unit security manager will be hand carried by the contract personnel to the 37 SFS Personnel Security Office for processing prior to contract performance. Upon completion, the contract personnel must return the AF FM 2583 to the unit security manager. 7.5 Listing of contract personnel. The contractor shall provide the CO and 37 SFS/SFAD a list of contract personnel within five (5) calendar days after receiving award or Notice of Award. The list shall include the name, social security number, and date of NACI investigation if contract work involves unescorted entry to Air Force-restricted or other sensitive areas designated by the installation commander. The list shall be validated and signed by the Contractor Representative. The Contractor shall maintain this listing throughout the tenure of this contract. Updated listings shall be provided when contract personnel status or information changes. 7.6 Freedom of Information Act Program. The Contractor shall comply with DoD Regulation 5400.7 Air Force Supplement and the DoD Freedom of Information Act Program requirements. The regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding "For Official Use Only" material. 7.7 Reporting Requirements. The Contractor shall comply with most current version of AFI 71-101, Volume 1, Criminal Investigations and Volume 2, Protective Service Matters requirements. The Contractor shall report to an appropriate authority any information or circumstances of which they are aware may pose a threat to the security of DoD personnel, Contractor personnel, resources, and classified or unclassified defense information. The contract personnel shall be briefed by their contractor or QA upon initial on-base assignment and as required thereafter. 7.8 Badges. The government will provide MTF ID badges and will be worn/displayed at all times. 7.9 Pager. When on-call, the contract personnel shall use the communication device (pager) or other electronic device issued by MTF. 7.10 Uniforms. The MTF shall furnish surgical scrubs. These items will be cleaned at the MTF's expense. 8.0 REPORTS AND DATA REPORTING REQUIREMENTS 8.1 The Contractor shall submit initial, quarterly, and annual reports to the QA and/or credentials office (as applicable) for use in monitoring performance. Such reports may include, but are not limited to: -Health and Immunization requirements (initially) -Personnel Changes (quarterly) -Basic Life Support (BLS) - (initially and renewal)* As accepted by American Heart Association (AHA) or American Red Cross (ARC) -Advanced Cardiac Life Support (ACLS) - (initially and renewal)* As accepted by AHA -Continuing Education Units (initially and annually) -Competency and currency of licensure/registration (initially and renewal) -Security (initially) -Timesheets (monthly) in WAWF 9.0 CONTINUATION OF ESSENTIAL DOD CONTRACTOR SERVICES DURING CRISIS: 9.1 The performance of these services is not considered to be mission essential during time of crisis. Should a crisis be declared, the Contracting Officer or his/her representative will verbally advise the Contractor of the revised requirements, followed by written direction. 10.0 APPENDICES: ATTACHMENT 1 CONTRACT SPECIFIC REQUIREMENTS PRIOR TO PERFORMANCE WILFORD HALL MEDICAL CENTER/59TH MDW FAXED TO:__________________________FAX:__________________DATE:_____________ Contract Position: __________________________________________ Name:____________________________________________________ The following items are Contract Specific requirements provided by the Contractor prior to performance: _______Pre-employment medical exam (no earlier than 45 days before start date) _______Immunization Record _______Varicella (serologic evidence of immunity or documentation of 2-shot series) _______Tdap Documentation of tetanus/diphtheria vaccination within 2 years or current Tdap vaccine.) _______TB- 2 Step Testing or Neg. Chest X-Ray for Past Positive Tests (see screening criteria below) Screening Criteria Required Testing No Previous Documented TST result Two-step baseline TST Previous documented Neg TST >12 months before new employment Two-step baseline TST Previous documented Neg TST < 12 months before new employment Single TST > 2 previous documented Neg TST but most recent TST >12 months Single TST Previous documented Positive TST Chest X-Ray (negative) _______MMR (Serologic evidence of immunity or documentation of 2-shot series) _______Hepatitis B (Serologic evidence of immunity or documentation of 3-shot series) _______HIV (direct contact with patients or body fluids) (Frequency shall be based on exposure risk per hospital employee program) _______Influenza (current series) _______Drug Testing _______Security Background Check ____SF 86 (If applicable) ____ State ____NAC ____LFC Affidavit signed and dated by the Contractor. Copy of signed AF FM 2583 or Sentinel Key verification printout from a Security Manager. _______Copy of license (if applicable) _______Copy of certifications (if applicable) _______Skills assessment checklist (if applicable) _______Credentials package (if applicable) ATTACHMENT 2 Referenced Air Force Instructions, Department of Defense Regulations, and Medical Wing Instructions (Note: In all instances, most current version applies.) o AFI 31-101, The Air Force Installation Security Program. (IAW MOA: CONS & 37SF) o AFI 31-401, Information Security Program Management. (IAW MOA: CONS & 37SF) o AFI 31-501, Personnel Security Program Management. (IAW MOA: CONS & 37SF) o AFI 33-202, Network and Computer Security. (IAW MOA: CONS & 37SF) o AFI 33-203, Emission Security. (IAW MOA: CONS & 37SF) o AFI 33-204, Information Assurance Awareness Program. (IAW MOA: CONS & 37SF) o AFI 41-210, Patient Administration Functions, Chapters 2 through 10 o AFI 33-322, Records Management Program, Paragraphs 1 & 2 o AFI 33-332, Air Force Privacy Act Program. (Entire instruction applies) o AFI 33-364, Records Disposition - Procedures and Responsibilities. (Entire instruction applies) o AFI 41-35, Health Record Documentation. (Entire instruction applies) o AFI 48-105, Surveillance, Prevention and Control of Diseases and Conditions of Public Health or Military Significance, paragraph 1.10.10. o AFI 71-101VI, Criminal Investigations. (IAW MOA: CONS & 37SF) o AFI 71-101V2, Protective Service Matters. (IAW MOA: CONS & 37SF) o AFMAN 37-123, Management of Records. (Entire manual applies) o AFMAN 37-139, Air Force Records Disposition Schedule. (Entire manual applies) o MDWI 10-4, Codes and Alarms. (Entire instruction applies) o MDWI 32-6, Fire Prevention, Fighting and Evacuation Program. (Entire instruction applies) o MDWI 40-1, Plan for Provision of Patient Care. (Entire instruction applies) o MDWI 44-9, Infection Control Program. (Entire instruction applies) o MDWI 44-102, Medical Care Management (Paragraph 3.7.2 to 3.7.5) o MDWI 44-142, Code Blue Management (Paragraph 8.4.1.) o MDWI 48-8, Hazardous Materials, Waste Disposal Spill Prevention & Management. (Entire instruction applies) o DoD Directive 5400.7, Freedom of Information Act Program, paragraphs 2 & 3 o DoDI 6040.40, Military Health System Data Quality Management Control Procedures, paragraph 2. o DoDI 6040.42, Medical Encounter and Coding at Military Treatment Facilities, paragraph 2.1 o DoDI 6040.43, Custody and Control of Outpatient Medical Records, paragraph 2.1. o DoDI 6025.8, Ambulatory Procedure Visit (APV) paragraphs 2.2., 2.3., and 2.4.
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Place of Performance: Address: Brooks City-Base, TX, San Antonio, Texas, 78235, United States; Zip Code: 78235
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Q -- This is a requirement for USAFSAM/Hyperbaric Division for a certified hyperbaric registered nurse