Instructions_Attachment_2_Technical_Self-Scoring_Worksheet.xlsx

XLSX spreadsheet 46 KB Posted Mar 21, 2017

Attached to: Medical Support Services Final RFP Federal contract opportunity
Solicitation number: 110515MSS01
Issued by: Defense Health Agency

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Draft RFP HT0014-17-R-0010 Instructions Attachment 2 Technical Self-Scoring Worksheet

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Instructions

a. The worksheet titled “Self Scoring Sheet” has 135 rows divided into 4 Categories: Scope, Magnitude, Complexity and Applicability. Within the Categories, there are 11 Sections that assess capability where points will be assigned based on the requirement. With each section are various elements of importance to the Government. Offerors should consider their past experience to attest to future technical capabilities for this solicitation. Offerors will be required to provide supporting documentation as proof of their technical capability for the sections and elements within those sections. Supporting documentation requirements is discussed in detail below.

The worksheet has Columns A through P that are explained below:

Column A is the Section number assigned to that capability element.

Column B is the RFP reference.

Column C is the capability being assessed.

Columns D through F are the level of capability that can be chosen by the offeror.

Column H is a subtotal by row and Section.

Column I shows the electronic file name for that Section/Element that will be used for scanned supporting documentation.

Columns J through P is a current point of contact for the supporting documentation/item who the government can contact to validate your claim of capability.

b. The Offeror shall follow the instructions listed below when filling out the rows of the worksheet. For convenience, the instructions are also included in a separate worksheet in the Technical Self Scoring Worksheet titled “Instructions.” Offerors will place an “X” in the proper cell; no other character or word will work in the cell to generate the correlating point value. It is important to note the government considers a task order under MAC ID/IQ contracts, a single contract.

§ Row 1: Enter Offeror name in Column C.

§ Scope Section (Rows 4 to 41).

§ Rows 5-19, Labor Category/Service Product Service Code Placement: Place an “X” in the appropriate Column D, E, F, or G associated with the highest number of FTEs placed on a single contract or order in the last 5 years: Certified (Row 9, Section 1, Element a), Specialized/Technical (Row 10, Section 1, Element b), Administrative/Clerical (Row 13, Element c), and Other Medical Support FTEs (Row 15, Element d). If the offeror never placed those types of labor categories/services, leave blank and complete Other Labor Category/Service in Row 17, Element e. Offerors may not complete Row 17, Element e if they have placed an “X” in the Columns for Certified (Row 9, Section 1, Element a), Specialized/Technical (Row 10, Section 1, Element b), Administrative/Clerical (Row 13, Element c), and Other Medical Support FTEs (Row 15, Element d).

§ Rows 22-32, Hard to Fill/High Turnover Positions: Place an “X” in the appropriate Column D, E, F, or G associated with the highest number of FTEs placed on a single contract or order in the last 5 years: Referral Clerk (Row 22, Section 2, Element a), Medical Appointment Clerk (Row 24, Section 2, Element b), Medical Office Clerk (Row 26, Section 2, Element c), Medical Records Technician (Row 28, Section 2, Element d), Outpatient Medical Coder (Row 30, Section 2, Element e), Beneficiary Services Representative (aka, PEBLO) (Row 32, Section 2, Element f).

§ Rows 34-40, Healthcare Setting: Place an “X” in the appropriate Column D or E, associated with your capability and experience in two performance settings: Outpatient Clinic (Row 36, Section 3, Element a) or Hospital (Row 38, Section 3, Element b). For this solicitation, an Outpatient Clinic is a standalone ambulatory care facility providing outpatient medical care. A hospital is a medical treatment facility capable of providing outpatient and inpatient services.

§ Row 41 is the subtotal for the Scope Category. Validate that the points were correctly calculated and transfer properly to the Total Points Summary worksheet, Row 5, Column B.

§ Magnitude Section (Rows 42-57).

§ Rows 44-47, Highest total Value on a single contract or order as the prime offeror: Place an “X” in the appropriate Column D, E, F or G.

§ Rows 49-52, Total Medical Support Service FTEs placed for the Government in the last 5 years. Place an “X” in the appropriate Column D, E, F or G.

§ Rows 53-56, Total number of active contracts or orders providing medical support services to the Government as of the date of the solicitation. Place an “X” in the appropriate Column D, E, F or G.

§ Row 57 is the subtotal for the Magnitude Category. Validate that the points were corrected calculated and transferred properly to the Total Points Summary worksheet, Row 6, Column B.

o Complexity Section (Rows 58-109).

§ Rows 63 – 80, High Demand Performance Locations. Place an “X” in Column D or E attesting to your historic capability of providing Medical Support Services in the listed performance locations. Offerors may enter one “Other” location and are required to specify the location in Row 82.

§ Rows 85-95, Hard to Fill Locations. Place an “X” in Column D or E attesting to your historic capability of providing Medical Support Services in the listed performance locations.

§ Rows 96-103, Prime Contractor Experience. Place an “X” in Column D or E attesting to your performance capability as the Prime or subcontractor.

§ Rows 106 – 108, Subcontractor/Team Management. Place an “X” in Column D or E attesting to your historic capability of managing teaming partners/subcontractors.

§ Row 109 is the subtotal for the Complexity Category. Validate that the points were corrected calculated and transferred properly to the Total Points Summary worksheet, Row 7, Column B.

o Applicability Section (Rows 110-135).

§ Rows 111-123, Customer Base. Place an “X” in Column D or E attesting to your historic capability of providing Medical Support Services to the listed customers.

§ Rows 124-129, Indefinite Delivery/Indefinite Quantity Contract Experience. Place an “X” in Column D or E attesting to your historic capability of performing on an Indefinite Delivery/ Indefinite Quantity Contract.

§ Rows 130-134, Firm Fixed Price Contract Experience. Place an “X” in Column D or E attesting to your historic capability of performing on a Firm Fixed Price Contract.

§ Row 135 is the subtotal for the Applicability Category. Validate that the points were corrected calculated and transferred properly to the Total Points Summary worksheet, Row 8, Column B.

c. The Offeror shall provide supporting documentation for each element in Scope, Magnitude, Complexity and Applicability which points are being granted in the Technical Self Scoring Worksheet. This documentation will be a scanned pdf file and will follow the required naming convention shown in Table 1 and in the Excel template. Offerors will highlight (by color or circling) the information in the document(s) that validate their claimed technical capability. The following are acceptable documents:

§ For Government Contracts with Contractor Performance Assessment Reporting System (CPARS) Reports: Provide a copy of the CPARS report in the Technical Volume as outlined in Table 1, Proposal Organization. Do not provide a contract-level CPARS if the item claimed was provided under a task order (provide either that Task Order CPARS or task order contract documents to attest your claim. The Offeror shall not consolidate requirements on multiple task/delivery orders to obtain a higher point value since task orders are considered a single contract under this solicitation. Likewise, the Offeror shall not consolidate requirements for different option periods on the same contract to obtain a higher point value as part of their supporting documentation.

§ For Government Contracts without an existing CPARS Report: Provide a signed copy of the SF 1449, SF33 or DD1155 along with other contract pages that show the claimed item (labor category, FTE, location, dollar value, etc.).

§ For Commercial Contracts: Provide a signed and dated letter from the customer that confirms the claimed element on the worksheet.

Supporting documentation must address the specific service being provided. A specific supporting document can be applied to more than one row on the Self-Scoring Technical Capability Worksheet as long as that document supports the claimed item.

Offerors are cautioned that the supporting documentation must demonstrate performance in the area claimed on the Technical Self-Scoring Worksheet (i.e., labor category, location, number of full-time equivalent [FTEs]. For example, if you are attesting to the government you provide 7+ FTEs in the Certified Medical Support Positions Product Service Code, the documentation provided must clearly show more than seven (7) positions on a single order or contract. The Government reserves the right to review any information related to the supporting documentation for validation only. The supporting documentation must match the services of this solicitation.

Self-Scoring Sheet

OFFEROR NAME:

VOLUME II - TECHNICAL CAPABILITY

RFP Ref

Item

Self Scoring Section

Point Value

Supporting Documentation

Section#

Category: SCOPE (Type of medical support labor categories/services provided AND setting)

Ref

Labor Categories/Services Placement

Enter an X in the appropriate column with the largest number of FTEs placed on a single order or contract.

Documentation* see instructions

Item Validation Information

FTEs Placed:

2 to 4

5 to 7

200

File Name (e.g., MY COMPANY.VOLII.LC&SV.TAB1a-e.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Certified Medical Support Positions (PSC Q601, 602, 603) - Points: 5, 10, 15, 15

FALSE

Specialized/Technical Medical Support Positions (PSC Q701 and Q702) - Points: 10, 15, 20, 25

FALSE

Medical Administrative/Clerical (PSC Q801 and Q802) - Points :15, 15, 20, 30

FALSE

Other Medical Support Positions (PSC Q999) - Points: 1, 1, 1, 2

FALSE

Other Labor Category/Service - Points: 1,1,1,2

[Type in labor category/service here]

Ref

Hard-to-Fill/High Turnover Positions

Enter an X in the appropriate column with the largest number of FTEs placed on a single order or contract.

Documentation

Item Validation Information

FTEs Placed:

2 to 4

5 to 7

150

File Name (e.g., MY COMPANY.VOLII.LC&SV.HARD.TAB2a-e.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Referral Clerk -Points: 5, 10, 10, 15

FALSE

Medical Appointment Clerks - Points: 5, 10, 10, 10

FALSE

Medical Office Clerk - Points: 5, 5, 10, 10

FALSE

Medical Records Technician - Points: 1, 4, 5, 10

FALSE

Outpatient Medical Coder - Points: 1, 4, 5, 5

FALSE

Beneficiary Services Representative (aka, PEBLO) - Points: 2, 2, 3, 3

Ref

Healthcare Setting (see note below)

Enter an X in the appropriate column associated with clinical settings

Documentation

Item Validation Information

Yes

No (0 points)

File Name (e.g., MY COMPANY.VOLII.TAB3a-c.SETTING.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Outpatient Clinic (30 points)

FALSE

Hospital (20 points)

NOTE: Outpatient Clinic - a standalone ambulatory care facility.

Hospital: A medical treatment facility capable of providing inpatient care. It is appropriately staffed and equipped to provide diagnostic and therapeutic services, as well as the necessary supporting services required to perform its assigned mission and functions. A hospital may, in addition, discharge the functions of a clinic.

SCOPE SUBTOTAL

Section#

Category: MAGNITUDE (Dollar value of medical support services provided)

Ref

Enter an X in the cell associated with the highest dollar value of a single order or contract.

Contract Value:

> $30K

> $30K but < $90K

> $90K but < $150K

> $150K

100

Documentation

Item Validation Information

Point Value:

File Name (e.g., MY COMPANY.VOLII.MAGNITUDE.TAB4a.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Highest total value (including all options) obligated on a single contract or order for the prime Offeror

Enter an X in the cell associated with the largest number of FTEs on a single order or contract.

FTEs Placed:

< 10

10-39

40-59

60+

100

Documentation

Item Validation Information

Point Value:

File Name (e.g., MY COMPANY.VOLII.MAGNITUDE.TAB4b.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Total Full-Time Equivalent contract workers placed for the Government in the last 5-years (only include medical support services as defined in the solicitation)

Active Contracts

< 10

> 10 but < 20

> 20 but < 30

> 30

100

Documentation

Item Validation Information

Point Value:

File Name (e.g., MY COMPANY.VOLII.MAGNITUDE.TAB4b.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Total number of active contracts or orders providing medical support services to the Government as of the date of the solicitation.

MAGNITUDE SUBTOTAL

Section#

Category: COMPLEXITY (Geographic Coverage)

Ref

High Demand Performance Locations

Enter an X in the appropriate column associated with contract performance in the following locations:

Yes

No (No points)

100

Documentation

Item Validation Information

File Name (e.g., MY COMPANY.VOLII.COMPLEXIBILITY.HIGH.TAB5a-j.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

National Capital Region (DC, Maryland, Virginia) - 30 points

FALSE

Nevada (10 points)

FALSE

California (10 points)

FALSE

Florida (10 points)

FALSE

Ohio (10 points)

FALSE

Texas (10 points)

FALSE

Mississippi ( 5 points)

FALSE

New Mexico (5 points)

FALSE

Illinois (5 points)

FALSE

Other (5 points)

[Type in Location here]

Ref

Hard-to-Fill Locations

Yes

No (No points)

Documentation

Item Validation Information

File Name (e.g., MY COMPANY.VOLII.COMPLEXIBILITY.HARD.TAB6a-e.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Hawaii (15 Points)

FALSE

Minnesota (15 Points)

FALSE

Alaska (10 points)

FALSE

Guam (5 Points)

FALSE

South Carolina (5 Points)

Ref

Prime Contractor Experience (Supporting documentation must be from the Prime Contractor)

Enter an X in the appropriate column associated with contract experience

Yes (points)

No (No points)

Documentation

Item Validation Information

File Name (e.g., MY COMPANY.VOLII.PRIME.TAB7a-b.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Performance as a Prime Contractor (20 points)

FALSE

Performance as a subcontractor (5 points)

Ref

Enter an X in the cell associated with the highest value ID/IQ or requirements contract

Number of subcontractors/team arrangements

Documentation

Item Validation Information

Point Value:

File Name (e.g., MY COMPANY.VOLII.MAGNITUDE.TAB8a.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Subcontractors managed on a medical support services efforts

COMPLEXITY SUBTOTAL

Section#

Category: APPLICABILITY (customer, role, Government contract experience)

Ref

Customer Base

Enter an X in the appropriate column associated with contract performance with the following customers:

Yes

Documentation

Item Validation Information

File Name (e.g., MY COMPANY.VOLII.APPLICABILITY.TAB9a-f.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Defense Health Agency [formerly TMA] (15 point value)

FALSE

Air Force Medical Services (15 point value)

FALSE

Army or Navy Medical Services (10 point value)

FALSE

Other DoD or Federal Agency (5 point value)

FALSE

Other (5 Points) - [Specify]

INDEFINITE DELIVERY/INDEFINITE QUANTITY (ID/IQ) CONTRACT EXPERIENCE

Ref

Indefinite Delivery/Indefinite Quantity (ID/IQ) Contract

Enter an X in the appropriate column associated with contract experience

Yes (25 points)

No (No points)

Documentation

Item Validation Information

File Name (e.g., MY COMPANY.VOLII.IDIQ.TAB10a.pdf) See Table 1, Proposal Organization

Location of Services

Contract/Task Order Number

Agency Name

Point of Contact First Name

Point of Contact Last Name

Telephone Number

Email Address

FALSE

Performance on an ID/IQ contract

FIRM FIXED PRICE CONTRACT EXPERIENCE

Ref

Firm Fixed Price (FFP) Contract

Enter an X in the appropriate column associated with contract experience

Documentation

Yes (25 points)

No (No points)

File Name (e.g., MY COMPANY.VOLII.IDIQ.TAB11a.pdf) See Table 1, Proposal Organization

Item Validation Information

FALSE

Performance on a FFP contract

APPLICABILITY SUBTOTAL

&"-,Bold"&12DHA MSS TECHNICAL CAPABILITY SELF-SOURCING WORKSHEET

FOR OFFICIAL USE ONLY - SENSITIVE DRAFT INFORMATION &P of &N

Total Point Summary

Offeror Name:

TOTAL SCORE

Technical Area

Scope	0
Magnitude	0
Complexity	0
Other	0
TOTAL POINT VALUE	0

File details come from the government source that posted it. Updated Nov 14, 2017.