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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

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     Indian Health Manual

Part 7, Chapter 6:  Manual Exhibit 7-6-2-C

Sample Format - FWAP Agreement for
Commissioned Corps Officers

The following constitutes an agreement between:  (Area) and (Commissioned Officer) of the terms and conditions of participating in the FWAP:

  1. The Commissioned Officer volunteers to participate in the FWAP and to adhere to the applicable guidelines and policies.  The Area concurs with Commissioned Officers participation and agrees to adhere to the applicable guidelines and policies.

  2. The Commissioned Officer agrees to participate in the project beginning _______________________.

  3. The Commissioned Officer's official tour of duty will be:______ to ______ on __________________, (e.g., 8:00 a.m. to 4:30 p.m. on Monday through Friday).

    * This is merely a sample item; the Area should tailor this item to fit the particular circumstances.  At a minimum, this item should cover the hours and days of duty for each worksite and flexibility of schedule if any.

  4. The Commissioned Officer will normally work________(Days of the week)__________ at their flexible workplace and will report to their official duty station every _______(Day of the week)_______ .

  5. The Commissioned Officer's official duty station is:___________________________ .  The alternate duty station (the location in which the Commissioned Officer is designated to work while not at the official duty station) is:____________________________.

  6. The Commissioned Officer's timekeeper will have a copy of the Commissioned Officer's FWAP schedule.  The Commissioned Officer's time and attendance will be recorded as performing official duties at the official duty station.

  7. The Commissioned Officers must obtain supervisory approval before taking leave in accordance with procedures established by the Commissioned Corps Personnel Manual.  By signing this agreement, the Commissioned Officer agrees to follow established procedures for requesting and obtaining approval of leave.

  8. The Commissioned Officer will continue to work in pay status while working in his/her residence.  Commissioned Officers cannot receive overtime, compensatory time, or credit hours.

  9. If the Commissioned Officer is provided Government equipment, the Commissioned Officer will borrow and protect the Government equipment in accordance with the procedures established in FIRMR Bulletin 30, October 15, 1985.  Government-owned equipment will be serviced and maintained by the Government.  In the event the equipment needs to be serviced/repaired, the Officer will be responsible for bringing the equipment to the appropriate personnel.  House calls for equipment repair will not be made.  If the Commissioned Officer's own equipment is used, he/she is responsible for servicing and maintenance.

  10. Provided the Commissioned Officer is given at least 24 hours notice, the Commissioned Officer agrees to permit periodic home inspections by the Government of the Commissioned Officer's home or worksite at periodic intervals during the Commissioned Officer's normal working hours to ensure proper maintenance of Government-owned property and worksite conformance with safety standards and other specifications in these guidelines.

  11. The Government will not be liable for damages to a Commissioned Officer's personal or real property during the course of performance of official duties or while using Government equipment in the Commissioned Officer's residence, except to the extent the Government is held liable by Federal Tort Claims Act claims arising under the Military Personnel and Civilian Employees Claims Act.

  12. The Government will not be responsible for operating costs, home maintenance, or any other incidental cost, (e.g., utilities), associated with the use of the Commissioned Officer's residence.  By participating in this program, the Commissioned Officer does not relinquish any entitlement to reimbursement for authorized expenses incurred while conducting business for the Government, as provided for by statute and implementing regulations.

  13. Commissioned Officers are entitled to medical care and disability compensation in the same manner as members of other uniformed services if injured in the course of actually performing official duties at the official duty station or the alternate duty station.

  14. The Commissioned Officer will meet with the supervisor to receive assignments and to review completed work as necessary or appropriate.

  15. The Commissioned Officer will complete all assigned work according to work procedures discussed between the Commissioned Officer and the supervisor.

  16. The Commissioned Officer's job performance will be appraised and reported on the annual Commissioned Officer Effectiveness Report.

  17. The Commissioned Officer may terminate participation in this project at any time.  Management has the right to remove the employee from the project for but not limited to the following reasons:  the employee's performance deteriorates, the arrangement fails to benefit organizational needs, etc.

  18. The Commissioned Officer's most recent performance rating of record must be at least an average of "C."  The Commissioned Officer's records must be clear of current or pending disciplinary actions.

  19. The Commissioned Officer's performance appraisal covers work completed at the office (official duty station) as well as work completed at the Commissioned Officer's residence (alternate duty station).

  20. The Commissioned Officer will apply approved safeguards to protect Government/agency records from unauthorized disclosure or damage and will comply with the Privacy Act requirements set forth in the Privacy Act of 1974, Public Law 93-579, codified at Section 552a, Title 5 U.S.C.

  21. The Commissioned Officer agrees to limit the performance of his/her officially assigned duties to his/her official duty station or to agency-approved alternate stations.  Failure to comply with this provision may result in termination of the flexible workplace arrangement and/or corrective action including disciplinary action(s).

  22. The Commissioned Officer is responsible for ensuring the safety and adequacy of the home workplace and for ensuring that applicable building and safety codes are met.  This includes but is not limited to the following situations:

    1. Assuring that the home's electrical system is adequate for the use of Government equipment;

    2. Safeguarding Government equipment from children and pets; and

    3. Providing smoke detectors if required by the applicable building code.  Commissioned Officers are encouraged to provide smoke detectors even if not required by the building code.

  23. All Government-provided equipment is for official business only.  Commissioned Officers are prohibited from using such equipment for private purposes.

  24. The Standards of Conduct continue to apply to Commissioned Officers at their alternate duty station.

Commissioned Officer__________________________ Date_________

Supervisor ___________________________________ Date_________

Approving Official____________________________ Date_________

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