Prolonged Exposure Therapy and Cognitive Processing Therapy for Combat-Related PTSD Workshop

The below requirement is changed to reflect the addition of "CPT" in Para 2.6 and the removal of the "Option Year" in Para 5.2. Request for Proposal, Performance Work Statement (PWS) Air Force Medical Operations Agency (AFMOA)/SG300 Office of the Surgeon General. Cognitive Process Therapy Clinical Training Workshops and Cognitive Processing Therapy Clinical Consultation Support. 1, The Government is contemplating the issuance of a Firm Fixed Price contract. The contract is for a one year period. Anticipated period of performance is 15 June 2008 through 14 June 2009. Please review the PWS dated 14 April 2008 and provide a complete proposal for the project. This is a "follow-on" requirement with an incumbent. The current effort is being provided by University of Texas Health Science Center, San Antonio Texas. 2, The period of performance is 12 months. We request you provide a proposal for this effort based on the attached PWS that addresses the following areas: - Comprehensive technical and management approach to accomplish the work effort. Describe knowledge and understanding the requirements as outlined in the PWS. The technical approach must identify the methodology and analytical techniques to be used to fulfill the technical requirements. The technical approach should clearly describe the following: o An overview of the proposed methodology in meeting the technical requirements identified in the PWS. o The logical sequence of tasks to be performed in order to accomplish the requirements. o Identify and describe the specific techniques and steps that will be applied during the accomplishment of all tasks of this project. o Any deliverables to be produced in response to project requirements. - Identify key personnel proposed for assignment to the project and skill level to include special qualifications of key personnel. Identify persons designated as Project Manager. Submit resumes of personnel; resumes should be no longer than 2 pages. - Describe the past performance that would qualify your firm for consideration. Describe corporate qualifications and capabilities related to the performance of the PWS requirements. Describe plan to staff and manage the service required in the PWS and include information detailing status reporting, location of management office and proposed teaming/subcontracting arrangements to be used in support of the requirement. - Provide a detailed cost estimate to include showing all labor categories, hourly rates and extended labor costs. Provide additional data to support any anticipated/proposed cost for Travel and Other Direct Costs. 3. The Government anticipates awarding a contract to the offeror whose proposal is the most advantageous to the Government, price and other factors considered. Award may be made to other than the lowest priced technically acceptable proposal. Technical proposals will be evaluated based on best value and the following factors with their relative weights: - Key Personnel qualifications .32 - Experience/Qualifications .27 - Technical Approach and clear understanding of the requirement .20 - Past Performance and corporate qualifications .14 - Cost/Price .07 Offeror price proposals will be evaluated to determine price realism and reasonableness. Prices that are excessively high or low may be considered unrealistic and unreasonable and may receive no further consideration. 4. Please e-mail Lt James Shaw a copy of your proposal and the cost proposal spreadsheets in Microsoft Excel format by 3:PM (CST) 9 May 2008. Performance on the work to be negotiated under this order shall not proceed until your firm receives a written notice from the Contracting Officer. 5. Should you require additional information, have questions or concerns, regarding the attached PWS or proposal requirements please forward them to this office so they can be addressed or clarified prior to submission of your proposal. Please contact James Shaw at Telephone number (210) 536-5774, FAX (210) 536-1918 or e-mail: james.shaw@brooks.af.mil if you have any other questions concerning the Request for Proposal. 1.0. INTRODUCTION. 1.1. The mission of the Air Force Medical Operations Agency (AFMOA) South is to support Department of Defense (DoD) health professionals in optimizing the health and wellness of their populations through appropriate, effective and efficient healthcare practices and service delivery. The United States Air Force (USAF) is committed to taking care of its own. Our Air Force (AF) members and their families deserve the best support possible. AF readiness targets combat stress reactions, deployment environment and deployment-related stressors. Tailored support of the base helping agencies targets deployment challenges and engages the services of base helping agencies. The AF community is represented by several agencies, one of which is the Office of the Surgeon General (SG), Community Behavioral Health Division (CBHD). 1.2. The USAF SG CBHD provides military readiness support through management of various programs engaged in individual, family and community health initiatives. These programs include Family Advocacy; Alcohol and Drug Abuse Prevention and Treatment/Demand Reduction; Education and Development Intervention Services/ Special Needs; and Suicide Prevention. Their objective is to address intervention and prevention strategies for common modifiable behavioral risk factors. 1.3. The challenge is recognizing the stressful situations of military members, specifically behaviors and concerns related to deployment stress. Congress has provided funding through the Department of Defense to the USAF to make available tailored support for pre-deployment, deployment, post-deployment, integration and combat stress reactions. There is an ongoing and urgent need to provide early psychological intervention as part of the first response to the traumatic events of pre- and post- deployment. 2.0. DESCRIPTION OF SERVICES. 2.1. Summary of Services Required. This contract will involve the implementation of Outside the Continental United States (OCONUS) three-day clinical training workshops, Continental United States (CONUS) two-day and three-day entry level clinical training workshops and four-day master clinician training workshops for military mental health provider (MHP), which include psychologists, psychiatrists, social workers, mental health nurses, and mental health technicians. The goal of these workshops is to train military MHP to provide prolonged exposure therapy (PET) and Cognitive Processing Therapy (CPT) in both deployed locations and in garrison for active duty military members with combat-related anxiety stress disorder (ASD) and PTSD. In addition, the programs will be evaluated to monitor training effectiveness (e.g., pre/post testing for knowledge), use of PE/CPT by clinicians (survey active duty clinicians who have been trained), and other outcome measures (e.g., providing consultation on use of the PCL-M). Authorization for delivering continuing education (CE) credits should be gained by the contractor and CE offered to all eligible workshop participants. The contractors will provide their own equipment for the presentations, including a laptop and projector for running slides, as well as audio support, wires and cables as needed to put on a workshop as described above. The contractors chosen for the delivery of these services will have had deployment training and experience in treating active duty service members returning from OIF/OEF. Contractors with experience treating exclusively retirees or those discharged from the military will not meet the requirements of this contract. 2.2. Workshop Materials will be updated and specifically tailored for the PET/CPT treatment of combat-related ASD and PTSD in United States (U. S.) military personnel in both deployed and garrison settings. This will include the creation and updates of workshop handouts, reprints of scientific publications, clinical assessment materials, psychological measures and a provider's treatment manual. The contractor will provide clinical training workshop and consultation materials during training to each attendee in hard copy and/or electronic media form. 2.3. CONUS PET/CPT Clinical Training Workshops: The contractor will conduct 8 PET three-day CONUS clinical training workshops and 1 PET four-day CONUS master clinical development workshop at the following locations and dates. The contractor will also conduct 3 CPT two-day CONUS clinical training workshops and 1CPT four-day CONUS master clinician development workshop. All costs associated with travel, food, lodging, creating and transporting the manual or handouts, and miscellaneous expenditures are to be borne by the contractor and are assumed to be covered in the agreed upon cost per workshop. The workshops will include a review of evidence-based interventions for ASD and PTSD with a specific emphasis on PET. Approximately twenty-five to fifty military providers will attend each workshop and attendees will receive workshop type training in the assessment and PET treatment of ASD and PTSD in CONUS and deployed locations. Clinical case examples, including audiotapes and video of treatment sessions of active-duty military patients with ASD and PTSD who were treated in Iraq, will be reviewed. Portions of the training will also target non-provider positions such as mental health technicians in order to give them some idea about what their role might be in the delivery of care in a deployed setting. Attendees will be provided copies of assessment tools and a treatment manual for PET treatment of combat-related ASD and PTSD. The Government reserves the right to readjust the workshop dates in accordance with military and ops tempo demands Planned PTSD Provider Training Training Dates Location Master Clinician Development Course (PET) 28 - 31 July 09 San Antonio, TX PET 12-14 Aug 08 Scott, AFB CPT 14-15 Aug 08 Hill, AFB PET 9-11 Sept 08 Tinker, AFB PET 23 - 25 Sep 08 Peterson, AFB CPT Master Clinician Development Course 6-9 Oct 08 San Antonio, TX PET 7-9 Oct 08 Pope, AFB PET 21-23 Oct 08 Charleston, AFB CPT 3-4 Nov 08 Tinker, AFB PET 4-6 Nov 08 Offutt, AFB PET 18-20 Nov 08 Nellis, AFB CPT 2-3 Dec 08 Dover, AFB PET 2-4 Dec 08 Edwards, AFB 2.4. OCONUS PET Clinical Training Workshop. The contractor will conduct 4 PET three-day OCONUS clinical training workshops at the following locations and dates. All costs associated with travel, food, lodging, creating and transporting the manual or handouts, and miscellaneous expenditures are to be borne by the contractor and are assumed to be covered in the agreed upon cost per workshop. The contractor will be compensated for one rest day prior to the start of the OCONUS workshops to allow for jet lag. The workshops will include a review of evidence-based interventions for ASD and PTSD with a specific emphasis on PET. Approximately twenty-five to fifty military providers will attend each workshop and attendees will receive workshop type training in the assessment and PET treatment of ASD and PTSD in CONUS and deployed locations. Clinical case examples, including audiotapes and video of treatment sessions of active-duty military patients with ASD and PTSD who were treated in Iraq, will be reviewed. Portions of the training will also target non-provider positions such as mental health technicians in order to give them some idea about what their role might be in the delivery of care in a deployed setting. Attendees will be provided copies of assessment tools and a treatment manual for PET treatment of combat-related ASD and PTSD. The Government reserves the right to readjust the workshop dates in accordance with military and ops tempo demands. Planned PTSD Provider Training Training Dates Location USAFE PET 18-20 Jun 08 Ramstein, AFB USAFE PET 23-25 Jun 08 Lakenheath, AFB PACAF PET 12-14 Aug 08 Elmendorf, AFB PACAF PET 13-15 April 09 Kadena, AFB 2.5 PET/CPT Training Evaluation. The contractor will implement a PET/CPT training evaluation for all attendees. Demographic evaluation will be collected on each participant including but not limited to training location, training dates, name, rank, branch of service, duty station, MAJCOM, professional discipline, email address, prior experience treating patients with PTSD, prior training experiences in treating PTSD. A pre/post knowledge assessment will be conducted with each workshop participant in order to evaluate learning, motivation, and confidence for using the PET/CPT techniques upon returning to the Military Treatment Facility (MTF). A follow-up evaluation of all attendees will be conducted within 6 months in order to assess motivation and confidence to use the PET/CPT model, number of patients treated, and patient outcomes, as measured by the PCL-M. 2.6 Telephone Consultation for PET/CPT Trainees. The Contractor will provide ongoing clinical consultation for all PET/CPT workshop participants, including psychologists, psychiatrists, social workers, and mental health technicians upon completion of the three-day PET training workshop. Telephone consultation will be used and a military call-in line will be provided when requested (e.g., Meet Me Line). The contractor will regularly send out notification emails of the phone number and times available for consultation in order to facilitate as much participation as possible. Consultation will be provided for the military MHP as they begin to see clinical cases (patients) at their assigned MTF, whether they are located within CONUS, OCONUS, or deployed to Iraq, Afghanistan or other locations in support of OIF and OEF. For all consultation activities, guidelines will be followed to ensure privacy and confidentiality of all patient information. For consultation with deployed providers, proper guidance and procedures will be followed in accordance with Communications and Information Management Guidance and Responsibilities (CIMGR), Air Force Instruction (AFI) 33-101 and Communications Security (COMSEC), AFI 33-201, Volume (V) 1. Consultation times will be available for up to twenty hours per month and will be arranged at times that are convenient to the MHP and consultant. This teleconsultation format will allow for both individual, as well as, small group consultation. 2.7 Telephone Consultation for PET/CPT Master Clinician Trainees. This contract will also involve providing consultation to approximately twenty-five military MHP; which include psychologists, psychiatrists, mental health nurses, and social workers, upon completion of the four-day master clinician PET/CPT training workshop on evidence-based treatment of PTSD. These individuals will be training to serve as future PTSD trainers and case supervisors. The Master Clinicians will require more extensive consultation than those attending the three-day workshop. Telephone consultation for Master Clinicians will include the review of audiotape/videotape assessment and treatment cases for which patients provide written consent for this clinical consultation. The contractor will regularly send out notification emails of the phone number and times available for consultation in order to facilitate as much participation as possible. Consultation will be provided for the military MHP as they begin to see clinical cases (patients) at their assigned MTF, whether they are located within CONUS, OCONUS, or deployed to Iraq, Afghanistan or other locations in support of OIF and OEF. For all consultation activities, guidelines will be followed to ensure privacy and confidentiality of all patient information. For consultation with deployed providers, proper guidance and procedures will be followed in accordance with Communications and Information Management Guidance and Responsibilities, (CIMGR), Air Force Instruction (AFI) 33-101 and Communications Security, (COMSEC), AFI 33-201, Volume (V) 1. Consultation times will be available for up to twenty-five hours per month and will be arranged at times that are convenient to the supervisee and supervisor. The teleconsultation format will allow for both individual and small group consultation. 2.8 SPECIFIC REQUIREMENTS. The contractor shall provide the following: 2.8.1. Ability to deliver 3 day PET trainings, 2-day CPT, and 4 day Master Clinician trainings 2.8.2. Workshops will be presented in a format relevant for many different disciplines including psychiatry, psychology, social work, nurses, and mental health technicians 2.8.3. Demonstrate at least 3 years experience in delivering PET to patients 2.8.4. Ability to demonstrate at least 1 year of personal experience in training others to use the principals of PET 2.8.5. Conduct a program evaluation including pre/post knowledge test 2.8.6. Conduct an outcome survey with those trained 2.8.7. Keep track of demographic information for all participants 2.8.8. Provide a manual for training in PET/CPT that is specifically tailored to AD mental health providers providing the latest information on combat related stress, Acute Stress Disorder, and PTSD in those participating in OIF/OEF 2.8.9. Provide own equipment for all presentations both CONUS and OCONUS 2.8.10. Demonstrated experience in developing protocols or conducting research in the area of Post Traumatic Stress Disorder 2.8.11. Provide audio and or video of PET case examples as well as scientific publications and training on PTSD assessment 2.8.12. Demonstrated history and or ability to provide Teleconsultation services as described above (e.g. Curriculum Vitae or cover letter) 2.8.13. The trainers must have a Doctoral Degree in Clinical Psychology with appropriate licensure in his/her state. 3.0. SERVICES SUMMARY (SS). The Government will periodically evaluate the contractor's performance by appointing a representative(s) to monitor performance to ensure services are received. The Government representative will evaluate the contractor's performance through inspection of deliverables and receipt of all complaints from customers. The Government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints. Likewise, the Government may decrease the number of quality control inspections if performance dictates. The Government representative shall make final determination of the validity of customer complaints(s). See Table 1 - Services Summary below: Performance Objectives PWS Paragraph Performance Threshold Surveillance Method Prepare and Submit Monthly Status Teleconsultation Financial Report. 8.1.1 No more than 1 Missing/late report during 6-month period. Periodic Surveillance Monthly Quarterly Report and End of FY Summary Report Describing All Activities Conducted 8.2 No more than 1 Missing/late report during 6-month period. Periodic Surveillance Quarterly Table 1 - Services Summary 4.0. GOVERNMENT FURNISHED SUPPORT. The Government will provide the location and space at the medical treatment facilities. If space is not available at the MTF then alternate locations will be provided by the Government. 5.0. GENERAL INFORMATION. 5.1. PLACE OF PERFORMANCE. Work will be conducted on-site at the medical treatment facilities and at identified conference locations. 5.2. PERIOD OF PERFORMANCE (POP). The POP for this contract will be for a period of one (1) year. 5.3. HOURS OF OPERATION. Normal duty hours are 7:30 am to 4:30 pm, Monday through Friday (excluding Federal Holidays), unless mutually agreed upon by Government and contractor personnel. Due to mission need or due to unforeseen acts of nature or emergency, the Government and contractor may agree to different duty hour/work days. Overtime is not authorized. 6.0. TRAVEL. Travel is required during the performance period of this contract. Dates and destinations are written in the contract but may be subject to change based on the military operational tempo and the needs of the Government. If and when travel occurs, the contractor will be required to arrange transportation and other travel-related requirements to ensure attendance by appropriate contract personnel at the best value for the Government and in accordance with Federal Acquisition Regulations (FAR) 31.205-46 Travel costs, available at http://farsite.hill.af.mil/vffara.htm. Travel will be performed only at the request and approval of the Government, within the scope of this contract. 6.1. Ability to travel to multiple CONUS and OCONUS locations. 6.2. Travel throughout CONUS/OCONUS infrastructure MTF will be required. 6.3. The contractor shall prepare and provide administrative documents sufficient to accomplish Government travel when required. 7.0. SECURITY. The contractor will not have access to Government computers or patient information. 7.1. The contractor personnel will work out of the contractors facilities and will not be using Government systems/computers. The contractor will come on base (various bases) only to conduct training. The contractor personnel will be escorted in the buildings where the training will be conducted. SGRM checked with AFMOA/CCE Security and as long as the trainers are escorted no National Agency Check (NAC) will be required for the trainers. 7.2. Contractor personnel will be escorted on base while performing under this effort. They will not require usage of e-mail nor a government computer. 7.3. Work performed under the contract is unclassified. However, the technical and medical privacy data used within the scope of this contract requires adherence to security/privacy requirements imposed by the Government, DoD, AF and other applicable security clearance requirements as applicable to this contract. The contractor shall handle and protect all data as directed and implemented by the AFMSA enterprise and its implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). (Appendices B). 7.4. Contractor personnel shall not release any personnel or medical/patient information to include patient/person-level content with personal health information, during the course of this contract. Information shall be treated IAW the following: 7.4.1. The Privacy Act of 1974 (5 U.S.C. - 552a), which includes Public Law 100-503, Department of Defense Directive (DoDD) 5400.11, and DoDD 5400.11-R and must be treated as FOR OFFICIAL USE ONLY. 7.4.2. The Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), which includes DoDD 6025.18-R and is FOR OFFICIAL USE ONLY. (Appendix B). 7.4.3. Other Military Health Services, AFMSA, Federal and State laws may also be applicable. 7.4.4. Contractor shall be required to furnish the Government Technical point of contact (POC) with signed Non-disclosure agreements, provided by the Government for each contract employee. (Appendix D). 7.4.5. Contractor shall provide patient information only to Government employees, Government Contractor, and subcontractors having a need-to-know such information in the performance of their duties for this project. 7.4.6. The COR must be kept abreast of issues dealing with the security clearances and/or certifications. No foreign national candidates shall be utilized within the scope of this contract without prior approval of the Government. 7.5. DATA RIGHTS. All products (software, coding, documentation, reports, or any other item developed under this contract) resulting from this contract shall be the property of the Government with unlimited rights, except as pursuant to 15 U.S.C. - 3710a(c)(7)(A) & (B), the Freedom of Information Act, 5 U.S.C. - 552, et seq. 7.6. INSPECTION AND ACCEPTANCE. Final inspection and acceptance of all work performed, reports, and other deliverables will be performed at the place of delivery or location designated by the COTR. Analysis and reporting work will be inspected at delivery to ensure requirements have been met. 7.7. CONTRACT PROGRAM MANAGER (PM) POC. The Contractor shall provide a POC for tasking, 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 Contractor shall designate this individual, in writing, to the CO and the COR before the contract start date. An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary point of contact. 7.8. PERFORMANCE EVALUATION MEETING. The Government may request the Contractor or his representative to meet with the CO, COR, COTR, contract administrator, Quality Assurance Personnel (QAP), and/or other Government personnel at least quarterly, or as often as deemed necessary. The Contractor may request a meeting with the Government when he deems it is necessary. Meetings will be documented in the contract file with written minutes signed by the contract manager or contract administrator. Should the Contractor not concur with the minutes, such non-concurrence shall be provided in writing to the COR and COTR within ten (10) calendar days of receipt of the minutes. 7.9. NON-DISCLOSURE AGREEMENT (NDA). The contractor shall adhere to the AF/SG NDA. The NDA shall be delivered and accepted prior to the period of performance. An NDA must be signed by each contractor personnel assigned to this acquisition prior to starting their designated tasks. (Appendix D). 7.10. Contactor personnel shall meet the requirements of this contract without further training, except for familiarization of Air Force policies and procedures. 8.0. DATA REPORTING REQUIREMENTS. 8.1. MONTHLY STATUS TELECONSULTATION FINANCIAL REPORT. 8.1.1. The contractor shall prepare and submit a monthly status Teleconsultation financial report identifying all tasks performed, future teleconsultation schedule, and demographics of teleconsultaiton participants as well as projected barriers to training consistent with the performance work statement (PWS) no later than the 10th day of the following month. Contractor Data Requirements List (CDRL) CDRL 0001. 8.1.2. A copy of this report shall be submitted to the Program Manager (PM) or the Contracting Officer (CO) by the tenth working day of the month following the end of the reporting period. 8.1.3. Specific format of the report shall be coordinated with the Program Manager and delivered in an electronic format mutually agreed upon by the contractor and the Government. 8.2. QUARTERLY AND END OF FISCAL YEAR STATUS REPORTS 8.2.1. Quarterly report and an end of FY summary report describing all activities conducted including the number of trainings (where and when), numbers trained, demographics of all individual trainees (i.e., service, duty station, MAJCOM, profession, email address, type of training attended, and date trained), summary of pre/post test scores across trainings, summary of evaluation feedback, and a summary of information gained from the outcome measures taken from trainees surveyed at the 6 month mark. 8.2.2. Status of COTR-generated action items, if any, from previous report and the resultant impact and schedule changes, if any. 8.3. STUDENT FEEDBACK. Each student will be provided a student feedback form at the end of each training workshop and these student feedback forms will be collected by the instructor and a summary report will be provided to the Program Manager. 9.0 CONTINUATION OF MISSION ESSENTIAL SERVICES (MES). The performance of these services is not considered to be MES during time of crisis. Should a crisis be declared, the contracting officer (CO) or his/her representative will verbally advise the contractor of the revised requirements, followed by written direction. 10.0 APPENDICES: 10.1. Appendix A. Performance Work Statement Acronyms. 10.2. Appendix B. Health Insurance Portability and Accountability Act (HIPAA) of 1996. 10.3. Appendix C. HQ USAF/SGR Organization Conflict of Interest. 10.4. Appendix D. HQ USAF/SGR Non-Disclosure Agreement (NDA). 10.5. Appendix E. Customer Feedback Form. APPENDIX A: PERFORMACE WORK STATEMENT ACRONYMS ACRONYM DEFINITIONS AD Active Duty AF Air Force AFI Air Force Instruction AFMOA Air Force Medical Operations Agency AFMSA Air Force Medical Service Agency ASD Anxiety Stress Disorder CBHD Community Behavioral Health Division CDRL Contractor Data Requirements List CE Continuing Education CFR Code of Federal Regulations CIMGR Communications and Information Management Guidance and Responsibilities CO Contracting Officer COMSEC Communications Security CONUS Continental United States COR Contracting Officer Representative COTR Contracting Officer Technical Representative CPT Cognitive Processing Therapy CSF Critical Success Factors DISA Defense Information System Agency DoD Department of Defense DoDD Department of Defense Directive FAR Federal Acquisition Regulation GFI Government Furnished Information HIPAA Health Insurance Portability and Accountability Act of 1996 HQ USAF/SG Headquarters United States Air Force Surgeon General JTR Joint Travel Regulation MAJCOM Major Command MES Mission Essential Services MHP Mental Health Provider MTF Military Treatment Facility NAC National Agency Check NDA Non-Disclosure Agreement OASD(HA) Office of Assistant Secretary of Defense for Health Affairs OCI Organizational Conflict of Interest OCONUS Outside the Continental United States OEF Operation Enduring Freedom OIF Operation Iraqi Freedom PCL-M Post Traumatic Stress Disorder Checklist-Military Version PE Prolonged Exposure PET Prolonged Exposure Therapy PHSD Population Health Support Division PM Program Manager POC Point of Contact POP Period of Performance PTSD Post Traumatic Stress Disorder PWS Performance Work Statement QAP Quality Assurance Personnel QCP Quality Control Plan SS Services Summary TO Task Order SAF Secretary of the Air Force SG Surgeon General USAF United States Air Force APPENDIX B: HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996 HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the DOD health plans are specifically listed as covered by HIPAA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPAA Privacy for DOD medical facilities is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for AF MTFs are contained in DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTFs. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTFs are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates. IAW these regulations, the Contractor and its employees meet the definition of Business Associates. Therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for each MTF, whereby the Contractor and its employees agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DoD 6025-18-R, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented. Introduction (a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8520.02-R or AFI 41-217. Individual has the same meaning as the term "individual" in 45 CFR 164.50 1 and 164.103 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 4...