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Family Medicine Physician - Military Entrance Processing Station (MEPS), U.S Naval Hospital Guam

Family Medicine Physician
Military Entrance Processing Station (MEPS)
U.S Naval Hospital Guam

Location: Services shall be provided at the Naval Hospital Guam.

The health care worker (HCW) shall provide comprehensive Physician services in support of the United States Naval Hospital Guam. Services shall be provided in the Physical Exam and MEPS Clinic.

During the term of the contract the HCW agrees to provide, on behalf of the Government, the services of a Physician, Family Medicine for treatment of active duty military personnel, their dependents, eligible Navy civilian employees, and other eligible beneficiaries, in accordance with the terms and conditions of the contract.

Duty hours: The HCW shall be on duty in the assigned clinical area for 40 hours week between the hours of 07 00 and 1800. The HCW shall normally provide services for an 8.5 hour period (to include an uncompensated .5 hour meal break), Monday through Friday. Specific hours shall be scheduled one month in advance by the Commanding Officer. Any changes in the schedule shall be coordinated between the HCW and the government.

When required, to ensure completion of services that extend beyond the normal close of business, the HCW shall remain on duty in excess of the scheduled shift. The HCW will be given an equal amount of compensatory time to be scheduled upon mutual agreement of the HCW and the Commanding Officer. The HCW shall use all compensatory time within a two week period. All unused compensatory leave will be forfeited, if not used at the end of the period of performance. If the Contract is terminated, there will be no reimbursement for any accrued compensatory time balance. In the event the HCW gives notice, all compensatory time must be used with the notice period or forfeited. This provision is not intended to apply to the time required to complete routine tasks (e.g., completion of paperwork or routine administrative tasks at the end of a shift), which are to be completed as part of the shift.

Holidays: The HCW shall not be required to provide service on federally observed holidays (10).

The Commanding Officer or designated Government representative will supervise the HCW.

Due to the nature of medical personal services which require government supervision, the need for access to Composite Health Care System (CHCS)/ Armed Forces Health Longitudinal Technology Application (AHLTA), and patients that present only at the Military Treatment Facility (MTF), the contract does not lend itself to allow for telecommuting.

MINIMUM QUALIFICATIONS To be qualified for this position the HCW must:

  • Be a graduate from a medical school approved by the Liaison Committee on Medical Education of the American Medical Association or the American Osteopathic Association or certification by the Educational Council for Foreign Medical Graduates (ECFMG).

  • Successful completion of a residency program in Family Medicine which has been approved by the Accreditation Council for Graduate Medical Education (ACGME) or the Committee on Postdoctoral Training of the American Osteopathic Association or those Canadian training programs approved by the Royal College of Physicians and Surgeons of Canada (RCPSC).

  • Possess current, valid, unrestricted license in one of the fifty states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands.

  • Possess and maintain a current Drug Enforcement Agency (DEA) registration number (certificate) to prescribe controlled substances as listed in 21 C.F.R. 1308 (verified after award).

  • Possess board certification in Family Medicine by the American Boards of Family Medicine or the American Osteopathic Association.

  • Possess at least one (1) year of experience within the last 3 years as a full-time Physician.

  • Possess current certification and maintain certification in Basic Life Support (BLS and Advanced Cardiac Life Support (ACLS). Web based classes do not meet these standards.

  • Provide two letters of recommendation written within the last two years attesting to clinical skills. A minimum of one of the letters must be from a supervisor. The other letter must be from either a clinic or hospital administrator, or a practicing physician. Reference letters shall attest to the quality and quantity of experience. The letters may also address patient rapport and the communication skills between practitioner and patient and among peers. Recommendation letters must include name, title, phone number, date of reference, address and signature of the individual providing reference.

  • Possess basic computer skills competency.

  • Represent an acceptable malpractice risk to the Navy.

  • Be in good standing and under no sanction or suspension listing by the Federal Government.

  • Possess U.S. citizenship which is necessary to gain access to DON IT systems and sensitive information.

  • If awarded a contract, the HCW will be required to obtain a physical examination and immunizations at their own expense prior to initiation of contract performance.

Duties: The health care worker (HCW) shall provide, in accordance with this statement of work, comprehensive Physician services in support of the United States Naval Hospital Guam. Services shall be provided in the Physical Exam and MEPS Clinic.

During the term of the contract the HCW agrees to provide, on behalf of the Government, the services of a Physician, Family Medicine for treatment of active duty military personnel, their dependents, eligible Navy civilian employees, and other eligible beneficiaries, in accordance with the terms and conditions of the contract.

While on duty, the HCW shall not advise, recommend, or suggest to individuals authorized to receive services at Government expense that such individuals should receive services from the HCW when he or she is not on duty, or from a partner or group associated in practice with the HCW, except with the express written consent of the Commander. The HCW shall not bill individuals entitled to those services rendered pursuant to this contract.

The HCW shall be physically capable of standing for extended periods of time and capable of normal ambulation.

The HCW shall comply with Executive Order 12731, October 17, 1990, (55 Fed. Reg. 42547), Principles of Ethical Conduct for Government Officers and Employees, and shall also comply with DoD and other Governmen t regulations implementing this Executive Order.

Suits arising out of Medical Malpractice. The HCW is serving at the military treatment facility under a personal services contract entered into under the authority of Section 1091 of Title 10, United States Code. Accordingly, Section 1089 of Title 10, United States Code shall apply to personal injury lawsuits filed against the HCW based on negligent or wrongful acts or omissions incident to performance within the scope of the contract. The HCW is not required to maintain medical malpractice liability insurance. In the event of a claim or lawsuit relating to the HCW's performance of duties under the Contract, the parties shall follow the procedures established in SECNAVINST 6300.3A, a copy of which can be viewed at http://doni.daps.dla.mil/default.aspx.

The HCW providing services under the Contract shall be rendering personal services to the Government and shall be subject to day-to-day supervision and control by Government personnel. Supervision and control is the process by which the individual HCW receives technical guidance, direction, and approval with regard to the requirements of the Contract.

Except as provided in this clause, the HCW is not prohibited from conducting a private practice of their professions or from engaging in other employment. However, the HCW shall not, simultaneously with performance under the Contract, engage in other employment that creates a conflict of interest, violates federal law, or potentially compromises the quality of their work under the Contract. Further, such private practice or other employment shall not be conducted during those hours in which the HCW are required to render services under the Contract. The HCW shall make no use of the Government facilities or property provided under the Contract in connection with other employment. (NAVMED P-117, Chapter 1, Article 1-22 applies (http://www.med.navy.mil/directives/Pages/NAVMEDP-MANMED.aspx).

The HCW shall be neat, clean, well groomed, and in appropriate clothing when in patient care and public areas. All clothing shall be free of visible dirt and stains and shall fit correctly. Fingernails shall be clean and free from dirt, and hair shall be neatly trimmed and combed. HCW shall display an identification badge, which includes the HCW’s full name and professional status (furnished by the Government) on the right breast of the outer clothing. Security badges provided by the Government shall be worn when on duty. In addition to the identification badge, the HCW shall self-identify as a Contractor in all meetings, telephone conversations, and formal and informal written correspondence with Government personnel.

The HCW shall read, write, speak, and understand the English language fluently.

The HCW shall arrive for each scheduled shift in a well-rested condition and shall have had at least 6 hours of rest immediately prior to reporting for the shift.

The HCW shall become acquainted with and obey all station regulations, shall perform in a manner to preclude the waste of utilities, and shall not use Government property for personal business. All motor vehicles operated on these installations by the HCW shall be registered with the base security service according to applicable directi ves. Eating by the HCW is prohibited in patient care areas and is restricted to designated areas. Smoking is prohibited in all facilities; the HCW shall comply with the rules and regulations of the MTF.

The HCW shall comply with all MTF checkout processes. These processes include returning Government property, i.e., identification badges, pagers, cellular phones, etc., to the MTF upon the HCW’s last day of service. Failure to do so promptly may result in delay of payment of the final invoice.

All financial, statistical, personnel and technical data which is furnished, produced or otherwise available to the Contractor during the performance of the Contract are considered confidential business information and shall not be used for purposes other than performance of work under the Contract. Such data shall not be released by the Contractor without prior written consent of the COR. Any presentation of any statistical or analytical materials, or any reports based on information obtained from studies covered by the Contract, will be subject to review and approval by the COR before publication or dissemination.

The Secretary of the Navy has determined that the illegal possession or use of drugs and paraphernalia in a military setting contributes directly to military drug abuse and undermines Command efforts to eliminate drug abuse among military personnel. The policy of the Department of the Navy (including the Marine Corps) is to deter and detect drug offenses on military installations. Measures to be taken to identify drug offenses on military installations, and to prevent introduction of illegal drugs and paraphernalia, include routine random inspection of vehicles while entering or leaving with drug detection dogs when available, and random inspection of personal possessions on entry or exit. If there is probable cause to believe that the HCW has been engaged in use, possession, or trafficking of drugs, the HCW may be detained for a limited period of time until he or she can be removed from the installation or turned over to local law enforcement personnel having jurisdiction. When illegal drugs are discovered in the course of an inspection or search of a vehicle operated by the HCW, the HCW and vehicle may be detained for a reasonable period of time necessary to surrender the individual and vehicle to appropriate civil law enforcement personnel. Action may be taken to suspend, revoke, or deny installation driving privileges. Implicit with the acceptance of the Contract is the agreement by the HCW to comply with all Federal and State laws as well as regulations issued by the Commanding Officer of the military installation concerning illegal drugs and paraphernalia.

Due to the nature of medical personal services which require Government supervision, the need for HCW access to CHCS/AHLTA (MHS Genesis), and patients that present only at the MTF, the Contract does not lend itself to allow the HCW to telecommute.

Comply with the standards of the Joint Commission, applicable provisions of law and the rules and regulations of any and all Governmental authorities pertaining to licensure and regulation of health care personnel and medical treatment facilities, the regulations and standards of medical practice of the MTF and the bylaws of the hospital's medical staff. Adhere to and comply with all Department of the Navy, Bureau of Medicine and Surgery and local Clinic instructions and notices that may be in effect during the term of the Contract.

HCW with a bona fide medical emergency occurring while on duty or with an on-the-job injury will be provided stabilizing medical care according to the procedures of the MTF. The HCW will reimburse the Government for all medical services provided unless the HCW is otherwise entitled to Government medical services.

Continuing Education: The Commanding Officer may also grant authorization for planned absences to allow the HCW to attend continuing education courses. This is in addition to the planned and unplanned absences specified above. The Government may compensate the HCW for these periods of authorized absence if the continuing education course(s) are determined to be a necessary expense by the government. This determination will be made on a case by case basis, weighing the costs associated with the training of Contractor personnel against the benefit gained by the Government in support of the appropriation that will incur the expense. This compensation will not exceed 80 hours per Contract period, equivalently apportioned for part-time services and/or partial year performance periods. The Commanding Officer may also advance leave for continuing education.

Unless authorized in advance, the Government will not reimburse the HCW for the cost of any training and/or other related expenses (travel). If authorized, the Contractor shall be compensated for those expenses deemed reasonable using a Travel/Training Contract Line Item Number (CLIN) in Section B. The HCW shall provide proof of attendance and successful completion of continuing education to the Commanding Officer upon request.

The HCW shall submit an invoice in accordance with Wide Area Work Flow (WAWF) instructions itemizing expenses in amounts allowable by the COR. (See Section G.)

All reimbursements will be retrospective, payable only upon presentation of a properly prepared invoice (as specified by the facility) to the COR. The Government shall reimburse the HCW only for actual training costs incurred, and any authorized travel expenses deemed reasonable.

The Government reserves the right to require additional documentation, including memoranda from the HCW obtaining the training.

Such training shall not be conducted prior to the appropriate funding being applied to the Contract.

For unusual and compelling circumstances (e.g., weather emergencies) in which the Commanding Officer either excuses all facility personnel from reporting to work or dismisses all personnel early, the Commanding Officer is authorized to grant administrative leave to the HCW. This administrative leave may be compensated leave.

Furlough: Except as otherwise provided in this paragraph or unless specifically authorized in a DoD Appropriations Act or a continuing resolution, the obligation of the Contractor to perform services under the Contract, and the Government's obligation to pay for such services, shall be suspended during a Government furlough. In the event of a Government furlough, the Commander will determine which Contractor employees are considered "essential" and therefore must report to work. Only Contractor employees deemed "essential" by the Government shall be compensated for services rendered during a furlough. All other Contractor employees will be furloughed until the Government shutdown ends or the COR notifies them that they have become "essential" employees.

Jury Duty: Administrative leave may be granted for a HCW selected to serve jury duty. Requests for administrative jury duty leave shall be submitted to the Commanding Officer in the same manner as planned leave is requested. The HCW is required to provide the Commanding Officer with as much written notice as possible prior to reporting for jury duty, and is responsible for supplying documentation regarding the necessity for and length of absence for jury duty. A HCW whose position is deemed critical by the Commanding Officer may be issued a written request for the court to excuse the HCW from jury duty. The HCW shall be compensated by the Government for these periods of authorized administrative leave.

DUTIES AND RESPONSIBILITIES: The HCW shall perform a full range of duties consistent with their labor category, education, training, experience, clinical privileges (as applicable), and assigned position.

Administrative duties: The HCW shall perform limited administrative duties which include maintaining clinical workload, participating in educational programs and participating in clinical staff quality assurance functions and process action team, as prescribed by the Commanding Officer. Administrative duties shall include, but are not limited to, the following:

Maintain a level of productivity comparable with that of other individuals performing similar services.

Comply with the standards of the Joint Commission, applicable provisions of law, and the rules and regulations of any and all governmental authorities pertaining to licensure and regulation of health care personnel and medical treatment facilities, the regulations and standards of medical practice of the MTF and the bylaws of the MTF’s medical staff. Adhere to and comply with all Department of the Navy, Bureau of Medicine and Surgery and local instructions and notices which may be in effect during the term of the contract.

Participate in peer review and performance improvement activities. Actively participate in the command’s performance improvement program by participating in meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.

Practice aseptic techniques as necessary. Comply with infection control guidelines to in clude the proper handling, storage, and disposal of infectious wastes, the use of universal precautions to prevent the spread of infections.

Function with an awareness and application of safety procedures.

Perform efficiently in emergency patient situations following established protocols, remaining calm, informing appropriate persons, and documenting events. Anticipate potential problems/emergencies and make appropriate interventions. Notify supervisor, director, or other designated person regarding problems that the HCW is unable to manage.

Apply an awareness of legal issues in all aspects of patient care and strive to manage situations in a reduced risk manner.

Participate in the implementation of the Family Advocacy Program as directed. Participation shall include, but not be limited to, appropriate medical examination, documentation, and reporting.

Exercise awareness and sensitivity to patient/significant others' rights, as identified within the institution.

Maintain an awareness of responsibility and accountability for own professional practice.

Participate in continuing education to meet own professional growth.

Attend and/or comply with all annual training classes required by the Command, to include but not limited to online annual training provided by the MTF: disaster training, infection control, maintaining Joint Commission compliance, Sexual Harassment, Bloodborne Pathogens, Fire and Safety, Chemical, Biological, Radiological, Nuclear and Explosives (CBRNE), and all other required training.

Participate in the provision of in-service training to clinic staff members. Provide training and/or direction as applicable to supporting Government employees (e.g., hospital corpsmen, students, etc.).

Attend and participate in various meetings as directed.

Perform timely, accurate, and concise documentation of patient care. Maintain documentation of all treatment provided in accordance with clinic directives, and prepare such records and reports as may be required. All records and reports must be legible. Abbreviations must be only those listed in local instructions.

Operate and manipulate automated systems such as CHCS, AHLTA, and Clinical Information System ( CIS), participate in clinical staff Performance Improvement (PI) and Risk Management (RM) functions, as prescribed by the Commanding Officer. Maintain DoD email account as directed. The HCW shall be responsive to all email and voicemail communications.

As commensurate with the position, exercise appropriate delegation of tasks and duties in the direction and coordination of health care team members, patient care, and clinic activities.

Comply with the HIPAA (Health Insurance Portability and Accountability Act) privacy and security policies of the treatment facility. Providers shall obtain/maintain a National Provider Identifier (NPI) in accordance with DOD and MTF policy/instruction, as applicable. (https://nppes.cms.hhs.gov)

Be officially evaluated at least semi-annually on performance and adherence to requirements of this contract.

Participate in executing the Emergency Preparedness Plan (drills and actual emergencies) as sche duled by the MTF (typically semiannually). The MTF shall prepare a personnel re-call list with personal contact information for all military, civil service and contract employees in advance for an actual emergency. The HCW shall provide personal contact information to the designated supervisor upon commencement of services. Should an emergency occur, the HCW shall be contacted with shift information and for accountability purposes.

CLINICAL DUTIES: The HCW shall perform a full range of Family Medicine Physician services, within the scope of clinical privileges granted by the Commanding Officer, on site using government furnished facilities, supplies and equipment. Workload occurs as a result of either scheduled or unscheduled requirements for care. The HCW’s productivity is expected to be comparable to that of other Physicians assigned to the same facility and authorized the same scope of practice. The HCW shall:

Conduct comprehensive physical examinations and make clinical judgements for suitability for military service per DoDI 6130.03 Medical Accession Standards and USMEPCOM UMR 40-1 Medical Qualification Program. The HCW shall perform routine military readiness exams, pre-deployment exams, post-deployment exams, special operations physicals, separation physicals, and retirement physicals for all branches of the military. The HCW shall present their findings and outcome of the Physical Exam assessment to the Chief Medical Officer.

TRAINING: The HCW shall attend a 2 week course funded by the Military Treatment Facility which trains the HCW on all medical aspects of the recruitment exam, familiarization of the DoDI 6130.03 Medical Accession Standards and USMEPCOM UMR 40-1 Medical Qualification Program, hands-on learning of the interview and physical exam, records reconciliation, and ensuring potential recruits have met the aforementioned standards.

PERFORMANCE IMPROVEMENT/QUALITY ASSURANCE. The HCW shall:

Participate with their supervisor in departmental and hospital performance improvement activities/risk management programs as prescribed, and make recommendations on improvement of work methods and organizational features.

Participate in pediatric staff quality assurance functions to include peer review and clinic performance improvement. Attend and contribute to scheduled meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.

ORIENTATION: Undergo an orientation and shall complete mandatory Navy and DoD on-line training as required. Orientation may be waived for personnel who have previously provided service at the treatment facility. DoD on -line training may require that the HCW enter their Social Security Number to document and track compliance with training requirements. Orientation shall include familiarization with the facility, introduction to the Quality Improvement Program, introduction to MTF rules and regulations, introduction to military protocols such as military structure, time and rank, acquisition of parking permits, proper infection control protocols and clarification of rights and responsibilities.

Orientation shall consist of Command Orientation and Information Systems Orientation. Comman d orientation of up to 40 hours includes annual online training requirements for topics such as but not limited to fire, safety, infection control, family advocacy, Chemical, Biological, Radiological, Nuclear, and Explosive Events (CBRNE) Basic Awareness, and various Navy required on-line trainings. Information Systems Orientation of approximately 24 hours includes the CHCS/AHLTA, and the Ambulatory Data System (ADS). In addition, HCWs identified as CHCS and/or AHLTA super-users shall undergo an additional 8 hours of information systems orientation.

CREDENTIALS REQUIREMENTS: Upon award, the HCW shall complete a Credentials Record (CR) prior to performance of services. Completed CR must be forwarded 30 days prior to performance of duties to the MTF’s Medical Staff Services Office (MSSO). The CR, maintained at the MTF, contains specific information with regard to qualifying degrees and licenses, past professional experience and performance, education and training, health status, and current competency (i.e. within 2 years) as compared to specialty-specific criteria regarding eligibility for defined scopes of health care services. BUMED Instruction 6010.30, enclosure 6 details the CR requirements. BUMEDINST 6010.30 is available from the COR.

If, during the Government's evaluation of the CR a negative current clinical competency assessment is determined, it will bring the MTF’s consideration of the HCW’s application for credentialing/privileging to an immediate close. Since granting credentialing/privileging is required as a condition of employment under this contract, a negative current clinical assessment will result in the issuance of a contract termination notice by the contracting officer under the clause at FAR 52.249-12.

If clinical privileges are summarily suspended or are being held in abeyance, pending an investigation into questions of professional ethics or conduct, performance under this contract may be suspended until clinical privileges are reinstated. No reimbursement shall be made and no other compensation shall accrue to the HCWs so long as performance is suspended or clinical privileges are held in abeyance. The denial, suspension, limitation, or revocation of clinical privileges based upon practitioner impairment or misconduct will be reported to the appropriate licensing authorities of the state in which the license is held IAW BUMEDINST 6025.13.

Background Investigations: By fulfillment of this position, the HCW will have access to Department of Na vy (DON) Information Technology (IT) systems and/or perform IT-related duties with varying degrees of independence, privilege, and/or ability to access and/or impact sensitive data and information. Therefore, the HCW shall be subject to Information Technology (IT)/Sensitive Information (SI) security requirements which include national and local background checks and a credit check in accordance with Secretary of Navy (SECNAV) Manual5510.30, as well as a criminal background check in accordance with the Crime Control Act of 1990. It should be noted that in order to receive access to the DON IT system(s) and the sensitive data necessary to perform the duties for this position, the HCW must be a U.S. citizen. The HCW shall be required to complete the paperwork necessary for the Government to complete the background investigations.

FAILURE AND/OR INABILITY TO PERFORM: Should the HCW be unable to perform duties under the contract due to medical or physical disability for more than 13 consecutive days, performance under the contract may be suspended by the Contracting Officer until such medical or physical disability is resolved. If performance under the contract is so suspended, no reimbursement shall be made and no other compensation, including annual/sick leave, shall accrue to the HCW so long as p erformance is suspended.

Any HCW demonstrating a health or safety risk to patients or staff may be immediately removed from service. In the event of such a removal, the Contracting Officer may issue a stop work order until the situation is resolved,

Any HCW demonstrating impaired judgment shall be removed from providing health care services. The Government reserves the right to remove any employee who, in the judgment of a licensed physician, is impaired by drugs or alcohol.

Any HCW with alcohol or drug abuse problems may be allowed to return to work under the terms of the contract only with prior Government approval.

REGULATORY COMPLIANCE REQUIREMENTS: Within 60 days prior to performance of services by the HCW, the HCW shall obtain, at their own expense, documentation of required immunizations and physical testing, and a statement from the HCW's licensed medical practitioner or a report of a physical examination. The physical examination and immunization documentation shall indicate that the HCW is free from mental or physical impairments that would restrict the HCW from providing the services described herein. The requirements are provided on the HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM, the current version of which is available at: http://www.med.navy.mil/sites/nmlc/Public_Docs/Physical%20Exam%20and%20Immunization%20Form.pdf. The Contractor shall always obtain the current version from the web page and shall have the form completed in its entirety in accordance with its instructions. The facility shall identify any incumbent HCW who is not required to complete this documentation after Contract award. Declinations shall only be permitted based on either the HCW’s religious convictions or medical contraindications (as documented by a qualified health care provider). The Hepatitis B vaccine declination can be found on the World Wide Web at http://www.osha.gov/SLTC/etools/hospital/hazards/bbp/declination.html.

Except for the HCW who decline Hepatitis B vaccine as given above, the Hepatitis B requirements given in the HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM, provide that the HCW must either show a positive titer or demonstrate persistent non-response to the vaccine. The HCW may be approved for service at the MTF prior to achieving a Hepatitis B positive titer or demonstrating a persistent nonresponse according to the following provisions:

The HCW must receive the first vaccination of his/her initial vaccination series prior to commencing service under the Contract and must complete the series not later than 6 months after commencing service and, if a negative titer is obtained, must complete the second series within another 6 months; or

The HCW who has completed his/her initial series and obtained a negative titer must commence his/her second vaccine series prior to commencing service and must complete the second series not later than 6 months after commencing service.

The HCW approved according to the provisions above will be considered persistent non -responders until there is evidence to the contrary and will be counseled by a licensed practitioner regarding the implications of nonresponse.

If the HCW fails to comply with the applicable schedule above, the Contract may be terminated if so directed by the Contracting Officer.

Except as provided in paragraph 6.2.3 or 6.2.4 below, or unless the HCW is otherwise entitled to Government medical services (e.g., an eligible beneficiary), no medical tests or procedures required by the Contract may be performed in the MTF. Expenses for all required tests and/or procedures shall be borne by the Contractor at no additional expense to the Government.

The HCW shall agree to undergo personal health examinations and such other medical and dental examinations at any time during the term of the Contract, as the Commanding Officer may deem necessary for preventive medicine, medical surveillance, performance improvement, or privileging purposes. These examinations will be provided by the Government. If the Contractor chooses, these examinations may be provided b y private physician or dentist, at no expense to the Government.

It is essential that the HCW be vaccinated annually against influenza according to Bureau of Medicine and Surgery, (BUMED) and Centers for Disease Control (CDC) guidelines aimed at reducing the impact of influenza disease in health care settings. The Government will provide the influenza vaccine free of charge. If the HCW chooses to be immunized by the Government, the HCW shall sign a waiver releasing the Government from legal liability in accordance with local procedures and policies. Alternately, the HCW may obtain the vaccine at another facility, with the HCW bearing the total cost, and provide proof of vaccination to the Government. If the HCW declines vaccination, a signed declination form shall be provided to the Government in accordance with CDC recommendations and MTF policies.

A HCW who does not show a positive antibody titer after immunization and appears to have a "non -immune" status must report varicella exposure to the COR. In accordance with CDC Recommendations, the HCW may be removed from patient care duties beginning on the tenth day following exposure and remain away from work for the maximum incubation period of varicella (21 days). In this instance, the HCW will be considered to be in a leave status.

Prior to reporting for service at an MTF, each contract HCW shall be screened at Contractor expense for risk of exposure to tuberculosis (TB) as part of the Health Examination and Immunization/Screening Requi rement Form in 6.2.1. If the HCW is determined to have a low risk of exposure, no further screening or testing is required under this Contract. The initial screening may be waived, at the discretion of the MTF, if the Contractor provides evidence of a prior low risk assessment by a licensed physician. If the initial screening results in a determination that the HCW has an increased risk of exposure to TB, the Contractor is responsible for ensuring that the HCW receives targeted screening and testing in accordance with CDC Guidelines for Health-Care Settings and submitting timely records of subsequent screening or testing to the COR.

BLOODBORNE PATHOGEN ORIENTATION PROGRAM: The HCW shall participate in the Command’s Bloodborne Pathogen Orientation Program. The HCW shall also participate in all required annual training and in periodic training for all procedures that have the potential for occupational exposure to bloodborne pathogens.

MANAGEMENT OF HIV POSITIVE HCW: The human immunodeficiency virus (HIV) positive HCW will be managed in accordance with the current CDC guidelines and Section 503 of the Rehabilitation Act (29 U.S.C. 793) and its implementing regulations (41 CFR Part 60-741).

PREVENTION OF THE TRANSMISSION OF HIV: The HCW shall comply with the CDC’s “Universal Precautions” for the prevention of the transmission of the HIV virus.

MANAGING THE CLINICAL RISK IN THE WORK ENVIRONMENT: The work environment inherently involves risks typically associated with the performance of clinical procedures. The HCW may be exposed to contagious disease, infections and flying debris, requiring the wearing of personal protection equipment such as scrub attire, gloves, masks, and eye protection.

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