B08_SOL_EXHIBIT_A_PWS_Final_24Sep_0001.docx

CLINICAL SERVICES FOR FEDERAL WILDLAND FIRE - PERFORMANCE WORK STATEMENT (PWS)

Amendment 0001 Table of Contents

1.0. BACKGROUND

Wildland Firefighter Health and Wellbeing is an interagency priority for the Department of the Interior (DOI) and the Department of Agriculture (USDA) Forest Service (FS) in accordance with Title VIII, Section 40803(d)(5)(B) of the Bipartisan Infrastructure Law (2021), which states that the Secretaries of the aforementioned federal executive departments shall, “establish programs for permanent, temporary, seasonal, and year-round wildland firefighters to recognize and address mental health needs, including post-traumatic stress disorder (PTSD) care.” Under this authority, the Joint (DOI/FS) Wildland Firefighter Behavioral Health program, was established to provide psychotherapy services for the wildland fire personnel through this contract solicitation. The psychotherapy services contract shall serve all federal wildland firefighters of the Bureau of Indian Affairs, Bureau of Land Management, the National Park Service, and the U.S. Fish and Wildlife Service of the DOI; and the Forest Service (FS) of the USDA. There are approximately 20,000 federal wildland firefighters (this total includes fire management, support, temporary, and seasonal employees) and nearly 2,000 dispatchers across both Agencies.[footnoteRef:2] [2: United States Government Accountability Office. Barriers to Recruitment and Retention of Federal Wildland Firefighters. November 2022. https://www.gao.gov/assets/gao-23-105517.pdf]

As recommended by the Government Accountability Office report, Barriers to Recruitment and Retention of Federal Wildland Firefighters, while some mental health services are available to wildland firefighters, they do not currently meet the specific needs of the workforce. This contract is the outcome of steps taken by both departments to expand access to evidence-based mental health services provided by clinicians. The nationwide shortage of mental health professionals, lack of culturally competent clinicians, high cost of care, and inadequate insurance coverage are substantial barriers to care for wildland firefighters. Less than one third of the general population live in areas where there are adequate mental health professionals available to meet the demand. For wildland fire employees, access to specialty care is compounded by the remoteness of their locations and lack of mental health professionals with fire experience. While demand continues to outpace capability and capacity, the high cost of care and inadequate insurance coverage issues continue to serve as obstacles to seeking treatment, particularly for temporary and seasonal staff. Therefore, it is the goal of this contract to fulfill the requirements of the Bipartisan Infrastructure Law and allow ready access to services that is evidence-based.

Wildland fire activities expose the workforce to potentially traumatic and emotionally charged events. Employees frequently work long shifts with inadequate rest and recovery and are repeatedly exposed to stressful scenarios that contribute to mental health issues. The physical and psychological stressors associated with emergency response activities may put them at increased risk of PTSD, depression, anxiety, burnout, suicide, and substance use disorders.

Work and environmental conditions further contribute to the short and long-term health risks such as physically demanding work, variable work schedules, exposure to smoke and many other environmental hazards. Research has found that rates of mental health conditions among wildland firefighters such as post-traumatic stress disorder, depression, and anxiety are higher than those in the general population. Additionally, there are higher rates of suicide ideation and substance use than what is seen in the general population. Similarly, recent research is also showing higher rates of certain mental health conditions such as depression, anxiety, and post-traumatic disorder in the dispatch community.

2.0. CONTRACT SCOPE

The Contract serves federal wildland firefighters and dispatchers within the US FS and DOI, including the Bureau of Indian Affairs, Bureau of Land Management, National Park Service, and U.S. Fish and Wildlife Service. For the purposes of this contract, wildland firefighters are defined as employees in fire retirement covered positions. Additionally, most dispatchers are also in fire retirement covered positions, as defined by 5 U.S.C. section 8331(21) and 5 U.S.C section 8401(14). This also includes temporary employees who occupy primary firefighter positions but are not paying into the retirement system because they are under a temporary appointment or intermittent work schedule. For the purposes of definition, wildland firefighters and dispatchers, may be referred to as eligible personnel or participant elsewhere in this document. Figure 1 - Distribution of federal wildland firefighters across the United States

The Contractor, in coordination with the COR, will develop screening questions to verify eligibility based on definitions seen above.

Federal wildland firefighters are employed through three hiring categories, including permanent (those who work year-round in permanent positions), permanent seasonal (those who have permanent positions but do not work year-round), and temporary-seasonal employees (those who are hired for a single fire season). Temporary-seasonal firefighters can reapply and be rehired for future fire seasons. Some permanent firefighters are “term employees,” with limited appointments or a “not to exceed” time limit of 1 to 4 years. Permanent-seasonal firefighters work a range of schedules, such as 36 weeks on and 16 weeks off (furloughed). Temporary-seasonal firefighters generally cannot work more than 1,039 hours over the course of the fire season.

Federal wildland workforce is widely dispersed, with some working large metropolitan areas (i.e., a recognized area with 50,000 or more inhabitants) and U.S. territories while many are located in the western regions and remote rural areas (see figure 1 for distribution of wildland firefighters). They can work locally or anywhere in the United States, and sometimes internationally, to be assigned to wildland fire incidents typically for 14 days, but up to 21 days. These assignments typically occur multiple times throughout each fire season. Below is a table of the regional distribution of Federal Wildland Firefighters for DOI and FS. Appendix 1– States and Counties with DOI and FS Federal Wildland Firefighters includes a more comprehensive breakdown of individuals by state and county.

In addition, the Contractor will be asked to provide services to DOI and FS firefighters and dispatchers up to 6 months after the employee leaves an active duty pay status. The six months of coverage of services will be extended to temporary-seasonal firefighters, terminated, and retired employees for a maximum of 6 months post-employment or while they are in furlough status. If an employee is no longer at their duty station due to retirement or furlough, the 30-mile rule may be expanded to 50 miles and based on their residence.

The joint program is designed as a specialized initiative to address the unique behavioral health needs of wildland firefighters and dispatchers. Unlike an Employee Assistance Program (EAP), which offers short-term, general mental health and wellness services (up to 6 non-medical counseling sessions) for the entire workforce, this requirement focuses on providing mid to long-term mental health services (up to 16 therapy sessions and assessment).

Table 1 – Distribution of Federal Wildland Firefighters by Geographic Region and Agency*

*Current estimates as of April 2024. Some remote and office-based positions are not captured in the table above.

This contract encompasses the development and delivery of all resources, personnel, materials, processes, training, equipment, and technology required to provide the wildland fire workforce with the following services:

Tasks:

1. Provision of therapy services, in person and virtually, by licensed and experienced mental health clinicians

2. Call center operations inclusive of provision of information on available services, referrals, and case management services

3. Access to licensed clinicians 24/7 for crisis situations achieved through call center operations

4. Implement web features to allow self-scheduling and provide search options.

Additional Tasks:

5. If requested by the Government, conduct psychiatric evaluation/psychological assessment for Worker’s Compensation purposes;

6. If requested by the Government, provide qualified clinicians for on site services;

7. If requested by the Government, develop training modules;

8. If requested by the Government, deliver trainings.

Services outlined above (1-8), will be available through a centralized framework. In person sessions shall be available and prioritized, upon request for psychotherapy sessions. Psychiatric evaluations shall be available in person or virtually as required. Services will be available in person or virtually based on the request and requirements as defined by the Government and in this PWS.

While some requirements are established, the needs of the wildland fire community are emerging and evolving. Therefore, the Contractor shall be proactive and flexible as those needs are clarified and possess the ability to quickly adapt based on demand. The intent is to have a contract that allows the Government to quickly address the changing landscape in the wildland workforce. The evolving needs of the wildland fire workforce may drive modification(s) of this contract to satisfy emerging requirements in a rapidly changing environment.

3.0. MANDATORY TASKS

3.1 DURATION OF CONTRACT

This Contract shall be for a period of five (5) years (base and four (4) option periods for one year each) beginning on the effective date.

3.2 TASK SPECIFICS

3.2.1 Therapy Services

The contractor shall ensure that therapy services offered through this contract are provided by independently licensed mental health providers with training and experience in evidence-based practices in the treatment of mental health disorders.

The overarching objective of therapy services offered through the underlying contract is to provide access to evidence-based interventions appropriate for the presenting issue and diagnosis. These services will involve a diagnostic assessment and the development of the best treatment plan, basing interventions on measurable, functional outcomes and symptom reduction (e.g., improved ability to work, improved performance on responsibilities at home, increased frequency or improved quality of social interactions).

The contractor shall provide a nationwide network of independently licensed master-level or higher clinicians, to include but not limited to the following::

a. Licensed Clinical Social Workers

b. Licensed Professional Counselors

c. Licensed Marriage and Family Therapists

d. Licensed Psychologists

3.2.2 Initial Assessment

The initial assessment appointment will be scheduled to occur within three (3) business days of the initial request for service for routine cases. Crisis counseling shall be available by telephone 24/7, and in the event of an emergency immediate crisis intervention shall be provided. For urgent cases, appointment for initial assessment shall be scheduled within 24 hours of contact. Appointments shall be offered at times and locations convenient and accessible to clients. To the extent possible, the Contractor shall defer to the choice(s) of the client with respect to language, gender, religious, cultural, and/or ethnic preferences when referring the client to a therapist.

The Contractor will provide outpatient therapy services to members of the federal wildland fire community, up to 16 sessions plus assessment per person, per year at no cost to the firefighter or dispatcher.

Guidance on appropriate selection and use of virtual care has primarily been developed outside of a mental health context, therefore in person care is prioritized. An in-person assessment shall be the standard in this contract. Upon careful consideration of the clinical presentation, the patient’s preference, their needs, and ability to access virtual mental health care shall be considered when developing a treatment plan. Requirements for initial assessment include:

· In person assessment

· The Government anticipates that the majority of wildland fire personnel receiving traditional 50 to 60-minute counseling sessions. In certain circumstances, certain participants may receive trauma treatment modalities that possibly require longer sessions (e.g., 90-minute sessions for prolonged exposure). These sessions may be provided in an office setting with a provider located within the local network provider and are within 30 driving miles of DOI or USFS workplaces. The ceiling of 16 sessions per year may be apportioned depending on the treatment requirements. For instance, prolonged exposure protocol may be available for up to 10 sessions, 90 minutes each.

· If there is substantial hardship and inability to meet the in-person requirement, the Contractor shall propose expansion of the mileage and propose solutions to enhance this ability.

· Electronically Health Record-integrated video or equivalent secured virtual option offered can help assure that disparities in care are not amplified by constraints on user’s access to technology as many reside in remote locations.

· Telephonic modality is not approved for ongoing treatment. However, if the participant is on a fire assignment or in a remote location where internet connection may be limited and it is an urgent matter, up to two sessions may be provided by telephone. State and licensure regulations supersede For wildland fire employees located in remote locations or who elect to participate in a virtual platform, the Contractor shall establish an infrastructure (i.e., equipment, clinicians, etc.) to provide video services for eligible wildland fire personnel who wish to access therapy via this media rather than in a therapist’s office. Therapy provided through these alternate means shall be conducted by professionals who meet the minimum requirements of the contract and shall be subject to the same requirements of face-to-face counseling.

Clinician responsibilities include:

1. Diagnosis

2. Identify behavioral health trends/issues

3. Develop therapy and treatment plans

4. Administer therapy and treatment plans

5. Monitor patient progress

6. Maintain patient records, by safeguards outlined in this PWS

7. Process patient referral and appointment requests

8. Perform case management functions in the context of optimizing linkage to appropriate medical services, including coordination with the participant’s managed care plan for further evaluation. This may involve coordinating with the participant’s medical team for additional referrals and services, as they are under the purview of managed care benefits.

3.2.3. Call Center Operations

The Contractor shall provide call center operations to enhance client experience and effective linkage to services and resources. Through this toll-free centralized number, the Contractor shall provide features to include screening, linkage to a therapist within the Contractor’s network, information, and/or referral tailored to the needs to the client. As part of the call center operations, the contractor shall provide case management services as noted in 3.2.2. above.

Services shall be available across the U.S. States and Territories with coverage primarily focused in the Western U.S., including many rural and remote settings. Furthermore, federal wildland fire components may port their existing dedicated phone lines to the Contractor.

The Contractor shall refresh its clinician database regularly to ensure that the information returned to the participant is reasonably guaranteed to provide vetted, active candidates. The call center operators shall curate relevant clinician information and other applicable resources to provide to the participant.

In the course of their normal duties, wildland fire personnel may become involved in potentially traumatic event(s) and/or be repeatedly exposed to series of events that that could adversely impact their mental health. These personnel would access or be referred for psychotherapy services.

The contractor shall provide services and personnel to facilitate access to higher level of care (e.g., intensive outpatient program, partial hospitalization program, residential, or inpatient care) for substance use disorders and mental health concerns commonly affecting first responders through assessment and referral. While ongoing case management is not anticipated as part of this contract, targeted coordination for referrals and care coordination to allow for linkage to services at the appropriate level of care are required, as noted on page 6. These services may include care coordination with the employee’s managed health care plan. The Contractor may refer the client to Employee Assistance Program, offered through the FS and DOI employee wellbeing programs and/or employee-sponsored health insurance available through the Federal Employees Health Benefits program.

Search for a clinician who is active in the network, is taking new clients, and has the relevant experience by the participant should be minimal with the Contractor striving to facilitate optimal match to promote rapid access and effective treatment based. The Contractor is responsible for ensuring that services are immediately accessible and responsive to employees. All calls shall be initially answered within sixty (60) seconds. The Contractor shall ensure that employees located in the U.S. States and Territories can contact the call center telephonically toll-free. During calls all transfer wait times to other intake coordinator/call center worker shall be kept under sixty (60) seconds.

Referral decisions for services beyond the capabilities of this contract shall be based on the employee’s:

a. Nature and severity of the problem

b. The individual’s insurance coverage and ability to pay

c. Location

d. Cultural, ethnic, gender or racial preferences

e. Other special needs of the client

f. Clients are referred to the type of treatment that is most effective.

The Contractor is responsible for ensuring employees and affiliates adhere to the policies and procedures when transitions in care and additional services are required. The Contractor is responsible for ensuring that these policies and procedures are reflected in the Contractor’s Business processes.

The Contractor shall make outbound calls to clients. Follow up calls shall be made to participants to ensure services met the requirements, needs and expectations of the caller. Additionally, to meet the changing needs of the clients and Government, other specific call back services may be added.

Access should be facilitated via answering service (or equivalent) with messaging capabilities, accessible 24/7. Participants should be contacted within 24 hours of a request for services.

3.2.4. Crisis Intervention

The Contractor shall make available, clinical assessments and crisis management services, to directly interact with callers in experiencing emergencies, acute/complex issues, or when the caller requests to speak directly with a therapist. In such circumstances, the call shall be transferred to the clinician. During these interactions, trained masters-level and above clinicians shall provide crisis intervention, resources, and linkage to care based on the presenting issue and clinical determination. This type of engagement and crisis intervention services may require the Contractor to be available on an emergency basis at periods other than normal working hours.

Given the dynamic nature of participants’ needs, the Contractor shall have the ability to provide rapid access, typically within 48 hours, for initial intake and establishment of a treatment plan including scheduled follow up. Additionally, the Contractor shall provide crisis intervention to participants who may be in crisis and in need for immediate intervention.

The Contractor shall have the capability to provide services in a timely fashion. This may include unscheduled work periods outside of normal business hours in cases of emergencies. Immediate assistance, including interventions by a qualified clinician, shall be made available in such cases. This may include unusual incidents requiring more immediate intervention, such as the aftermath of line of duty deaths and serious accidents.

The Contractor shall have a comprehensive, effective, and efficient methodology to meet this requirement, prioritizing access to treatment and continuity of services. The Government anticipates callers to have a variety of needs with nuanced clinical presentation. High complexity category is defined below. All other types of calls shall be bundled and considered routine services as part of the call center functions.

High complexity:

a) requires intervention by a licensed clinician due to acute nature of the presenting issue and level of distress (e.g., active suicidality, homicidality) or;

b) requires coordination with emergency services and/or;

c) requires coordination for admission to emergency department (ED) for psychiatric evaluation and/or psychiatric hospitalization.

Situations that fall into the high complexity category, the Contractor connects individuals in a mental health crisis to needed care, including telehealth support services delivered by the Contractor itself. Recognizing the clinician's limited ability to verify insurance and identification over the phone, this specific service serves as a safety net for which the crisis intervention element may be billed separately through this contract.

In emergency situations, the Contractor shall facilitate transition of the individual in crisis to emergency or crisis services (e.g., 911, 988). This Contract does not reimburse for emergency department encounters, prescriber services, psychiatric hospitalizations, or engagement in higher level of care (IOP, PHP, residential programs) as claims for these service categories are under the purview of the employee's managed care plan.

3.3. REQUIREMENTS FOR THE CLINICAL SERVICES PROGRAM

The Contractor shall provide services and resources to manage and operate the FS and DOI’s therapy services for the federal wildland fire community. Coordinated services, including initial screening, psychotherapy sessions, call center operations, crisis intervention, referrals, and information shall be provided as part of this contract. As the Joint Wildland Firefighter Behavioral Health Program, referred to as JP hereinafter evolves, the Contractor shall provide these services as directed and approved by the Wildland Firefighter Behavioral Health team (e.g., Contracting Officer Representative (COR), Director/Program Manager, and authorized Government personnel).

Services shall be provided as necessary and as requested at the task order level in areas where USFS and DOI employees in primary wildland fire positions are located. The Contractor shall provide face-to-face and virtual psychotherapy services across the U.S. States and Territories with coverage primarily focused in the Western U.S., including many rural and remote settings Telehealth and face-to-face service options will be available in each state and territories. While face-to-face mental health service delivery in rural settings can be challenging, availability of in-person service options is a high priority. In-person services should be available within 30 miles of a firefighter and dispatcher’s duty station.

The Contractor shall work with the Government to create synergy in overall operations of the Wildland Firefighter Behavioral Health Program. This includes supporting the Government’s approach and framework; furnishing up to date information on qualified clinicians in various locations. The Contractor shall collaborate with identified Government points of contact to optimize regional needs and opportunities.

3.3.1 Covered Services

The contractor shall provide outpatient psychotherapy services, which are evidence-based mental health therapy modality conducted with individuals.

3.3.2 Exclusions

Psychiatric services, such as evaluation for medication, medication management, or specialty services such as a transcranial magnetic stimulation and higher levels of care such as intensive outpatient, partial hospitalization, and residential programs, are not covered as they must be coordinated through the employee’s own managed care entity (i.e., insurance). Additionally, retreats, which often do not use evidence-based methods of treatment, and psychological testing are not covered. Only outpatient psychotherapy and psychiatric evaluation services, are covered.

3.3.3 Scope of Care

Services provided by the Contractor will include assessments through face to face or virtual options and psychotherapy sessions. Based on the assessment, the clinician will develop an effective treatment plan based on evidence-based modalities. These services shall focus on Axis I mental health and substance use disorders. Individuals seeking services that are determined to be in scope of care include those who meet criteria for mental disorders found in the Diagnostic and Statistical Manual of Mental Disorders – 5th TR edition or the latest version. Additionally, common wildland fire-related stressors are addressed to prevent the development or exacerbation of mental health conditions that may detract from readiness.

Emergency responders, including wildland fire personnel are exposed to trauma, work long shifts with inadequate rest. The lack of sleep, long working hours in isolated locations, and repeated exposure to stressful scenarios risk factors for developing mental health conditions. Therefore, services provided by the Contractor will address effects of work-related exposure to stress and trauma experienced by wildland fire personnel. Minimization of barriers to care such as clinician-switching or changing between employee service support systems are high priority of the wildland firefighter behavioral health program and this contract. To assure continuity of care, prevention, and early intervention, the contractor shall provide services that address common wildland fire-related stressors to address sub-clinical symptoms and services that may help prevent the development of more severe conditions. Particular attention is paid to use of evidence-based protocols for the treatment of Post-traumatic Stress Disorder.

Wildland fire personnel with primary presenting concerns that are not work-related and not related to job duties of first responders, do not meet the scope of care criteria, and should be referred to the agency’s EAP. General service needs such as family and marital counseling, coaching, legal and financial consultation, and resources related to childcare, eldercare, pet care, adoption and academic concerns should be referred to the agencies’ EAP provider.

Critical incident stress management responses (i.e., defined as critical incident stress management across both agencies, currently) shall not be offered through this contract. However, individuals involved in fire and related incidents, as defined by the program leadership and COR, may be eligible to seek individual therapy services through this Contract. These events may be acute in nature and/or the result of cumulative effects impacting particular units.

While some presenting issues may be appropriate for EAP services, screenings that indicate substance use concerns, anxiety, depression, suicidality, acute stress reactions, or complex grief resulting from or exacerbated by the individual’s duties, such as potentially traumatic events or cumulative emotional strain of wildland fire work are appropriate for services under this contract. In addition, issues related to adjustment, separation, deployment, burn out, and reintegration issues as the result of the individual’s duties shall the covered under this contract. These conditions may require more intensive interventions than short-term counseling or crisis intervention would provide.

Given the dynamic needs of the wildland fire workforce, additional employee categories may be added during the life cycle of this contract, including cache and unit officers. Additionally, the annual number of sessions per eligible employee may be increased or decreased slightly based on demand, need, and funding parameters.

3.3.4 Affiliate Provider Network

The Contractor shall maintain adequate network of affiliate therapists, ensuring coverage in all locations where FS and DOI employees work and live. In large metropolitan areas (i.e., a recognized area with 50,000 or more inhabitants), the Contractor shall ensure that there are an adequate number of clinicians to provide services to FS and DOI employees within a reasonable commuting distance from work or home, defined herein as no further than thirty (30) miles. In remote locations where qualified mental health professionals may not be readily available within the prescribed distance requirement, the Contractor shall provide alternative plans for servicing clients (e.g., expanded distance for clinician access, remote services). The method for the delivery of care shall be based on distance, effectiveness of participant’s preference, and availability (i.e., face to face or virtually), whichever is available first. Of note, in person treatment should be prioritized to increase efficacy of evidence-based care.

The Contractor shall develop and implement a comprehensive approach and process for managing an expansive network of clinicians, ensuring appropriate and sufficient coverage, timeliness and efficiency of service delivery, and avoiding degradation or disruption of services. This approach shall account for the complexities of network providers who are geographically dispersed and in remote areas. The Contractor, in coordination with the Government, shall provide an orientation about wildland fire to new affiliate therapists. Affiliate therapists shall not provide services until they have received the orientation, which may be accomplished virtually, in person, or via written communications as determined by the Government.

After the initial orientation, routine refresher trainings may be required. The frequency and extent of refresher trainings will be as determined by the Government. When required, the Government will provide at least 30-day notification to the contractor.

As data and trends are identified in different regions where wildland fire personnel are located, the Contractor shall proactively and actively recruit and add clinicians to meet requirements during peak seasons.

3.3.5 Therapist Qualifications

All clinicians providing services through this contract must maintain licensing and certification requirements. Clinicians must possess a master’s or doctorate degree in a mental health field at the highest independent licensure level in the state, territory, or the District of Columbia where services are provided. Eligible clinicians will possess at least two years of post-licensure experience treating mental health concerns known to affect wildland firefighters and dispatchers such as (but not limited to): depression, anxiety, substance use difficulties, and PTSD using evidence-based therapy modalities. The contractor shall ensure that clinicians meet the following requirements:

a. Clinicians will have maintained recent clinical practice, providing direct patient care for at least 3 of the past 5 years.

b. No disciplinary actions taken by any state licensing or other authorizing agency, or by any professional conduct board, and there have been no reprimands, or fines by any state agency that disciplines allied health professionals.

c. At least 30% of the therapist network must have demonstrated (e.g., certificates, resume, trainings) experience working with the first responder population. These clinicians should provide accessibility throughout the nation, where duty locations are located.

d. Complete a training for occupational and cultural awareness of wildland firefighting, delivered in person or virtually, to be provided by the Agencies. The contractor shall certify, upon award, and each option period, that all clinicians are in possession of education and experience required, and possess all other qualifications as indicated in the PWS prior to beginning work with a wildland fire employee.

e. The contractor shall inform the COR of any clinicians that have been placed on probation and/or remediation or have been removed from the network and reason for removal.

f. The Contractor will identify clinicians within its network in each state who have specialized training in treating PTSD and trauma-related concerns using evidence-based interventions for PTSD/trauma including modalities such as Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Processing Therapy, Prolonged Exposure, Cognitive Therapy. The Contractor will identify clinicians within its network in each state who have experience (demonstration of 2+ years) working with first responders.

The Contractor will have capacity to identify clinicians in their network who are trained in evidence-based treatments for trauma; clinicians who have specialized training and experience addressing the needs of first responders and veterans; and clinicians who have completed training in wildland firefighter cultural competence training.

The Contractor shall establish, enhance, and expand a network of clinicians who provide evidenced-based protocols for the treatment of mental health conditions and substance use disorders, promote resiliency among the wildland workforce; reduce and address burnout.

3.3.6 Credentialing

The Contractor shall submit required documentation and/or attestation that all network clinicians and staff providing oversight of clinical services have valid licenses and have undergone credentials review/verification of all tasks to be performed under this contract, prior to the provision of services.

The Contract shall identify, within its network, clinicians with specialized first responder training and experience. Additionally, clinicians with experience and training in the treatment of trauma shall be identified. This information shall be made readily available to the COR during in transition-in period (see 3.6.3 below) and prior to providing clinical services to participants.

The Contractor shall annually certify and be able to demonstrate (at any time) to the CO and COR, in writing, that the network clinicians and staff that provide oversight to clinical services, licensure, credentials, proof of insurance, and required experience are current and proper for performance under this contract. The contractor shall further certify that all other qualifications that are indicated in the PWS are fulfilled prior to beginning work with a participant. The contractor shall securely maintain certifications, private sector background check reports, and other required documentation for the life of this contract, and it shall make them available for Government review at any time. In addition, as part of the certification process, the contractor shall fully vet new personnel and/or newly assigned personnel before performing under this contract to ensure that they are able to successfully perform his/her duties under the contract in a professional manner. This vetting process shall include reasonable efforts to determine if a staff or network provider has ever been removed from performing on any other therapy or non-medical counseling support services contract or terminated, removed, quit in lieu of termination, or otherwise prohibited from performing clinical services for any public or private employer. The Contractor shall take immediate action to mitigate risk for the participant and Government.

3.3.7 Exclusions

The CO in consultation from the COR, may direct an affiliate or employee of the Contractor to be excluded from working on this contract. Any affiliate or employee of the contractor found or deemed to be unfit or whose continued association or employment on the contract is deemed contrary to the public interest or inconsistent with the best interest of the agency may be removed.

3.3.8 Personnel Requirements

The Contractor shall ensure optimal distribution and supply of clinicians to ensure access to quality services provided by licensed mental health professionals across the country. The Contractor shall notify agency in writing within seven (7) calendar days if a clinician’s license is suspended, revoked, voluntarily relinquished, or subject to terms of probation or other restrictions. Contractor will remove the said clinician’s information from the list used by the Government and its beneficiary population within 10 calendar days.

The Contractor shall notify the COR in writing within three (3) calendar days if any other situation occurs which will materially affect the Contractor’s ability to carry out their duties and obligations under this Contract.

All network providers and personnel employed by the Contractor or Subcontractor performing any part of this requirement, or having access to any data, information, or work product generated during the performance of this contract, shall be U.S. citizens and speak fluent English. Some locations may require clinicianss to speak Spanish fluently to effectively provide services and information to participants. The Contractor shall provide licensed therapists who speak Spanish fluently for some locations (e.g., Puerto Rico, Texas, and California).

Contractor or subcontractor personnel performing any part of this requirement shall not transport any client in any vehicle and shall not physically enter a participant’s home at any time.

Prior to the start of clinical service delivery, network providers and staff shall undergo orientation to wildland fire services organized by the COR. This may include the requirement to attend annual refreshers as determined by the Government.

3.3.9 Clinical and Professional Direction

The qualifications of Contractor personnel are subject to review by program personnel (i.e., Director, Wildland Firefighter Behavioral Health or designee, and COR). The parties agree that the Contractor and all contract clinicians shall not be considered federal employees for any purposes. Contractor and Contract clinicians and those affiliated with the contract shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of federal program priorities for budget requests, and interpretation of federal policies.

Contractor shall provide the number of qualified staff as is necessary to perform the services required under this contract, at the staffing level determined to be professionally acceptable by the COR.

The Contractor shall be responsible for providing continuity of care during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations, and additional coverage as required. In the event a clinician is unable to provide sessions as required (e.g., departs practice or network), the contractor shall identify and provide replacement clinician that matches the clinical background, expertise, and background to effectively complete the treatment plan.

Employees directly working for the Contractor and network clinicians affiliated with the Contractor will not imply or engage in self-promotion to secure clinical referrals from individuals using these services.

Should a wildland fire employee express interest in services beyond what is provide by this Contract, the vendor shall provide information including any private pay, insurance, or sliding scale options. The Contractor shall explicitly inform the participant of the scope of this contract.

3.3.10 Non-Disclosure Agreement (NDA)

All Contractor personnel performing work under this contract shall have executed a corporate-level NDA. The privacy of participants is of the utmost importance, and the Contractor shall provide the completed form(s) to the IDIQ COR before any employee has access to any information, materials, or documents pertaining to the contract.

3.4 PARTICIPANT FEEDBACK

In support of continued efforts to improve the quality of services delivered, with the participant’s approval, the contractor shall obtain, directly from the participant, feedback after the initial session and after case closure; utilizing a participant’s feedback questions approved and/or provided by the Government to ensure a consistent high level of quality. Feedback opportunities shall be made to participants in order to ensure that services delivered meet the requirements, needs, and expectations of the participant and to document outcomes and effectiveness of services delivered. Approval to contact shall be obtained from the participant on their original contact or request for assistance. At the direction of the Government, the contractor may be requested to utilize other additional feedback questions or instruments. Participant feedback will be provided in raw data (unedited) format to the Government, as requested.

3.5 BUSINESS PRACTICE REQUIREMENTS

3.5.1 Use of logo and data collection

The Contractor’s name or corporate logo, as well as any reference to the contractor, shall not be included in/on any documentation, literature, or materials associated with the joint program or any of its various domains. All participant and call center data collected pursuant to the performance of this contract are the property of the Government at all times and shall be retained by the Government upon contract completion and shall not be used by the contractor except in performance on this contract.

3.5.2 Media Inquiries

The Contractor shall remain free of any political bias and ensure consistency of service. The Contractor staff, including network clinicians shall not speak to the media or press regarding the joint program or their work with FS and DOI wildland fire participants without specific written approval from the CO and COR. Contractor staff including affiliated clinicians shall not engage in political discussions with participants concerning FS or DOI policy as they shall remain focused on providing psychotherapy services.

3.5.3 Press/news release

The contractor shall not make any press/news release pertaining to this contract without prior Government approval and only in coordination with the CO.

3.5.4 Approval of Materials

The Government shall review and approve of all public and employee facing materials. If revisions are required or requested, the Contractor shall make them at no additional cost to the Government. The Contractor shall provide goods and services acceptable to the Government in accordance with the standards customarily adhered to by a qualified, experienced, and competent clinician using skills and degree of care exercised by highly regarded professionals.

3.5.5 Payment Handling

The Contractor shall guarantee payment for exam services scheduled under this contract and ensure no personal insurance information or payment is collected from examinees scheduled under this contract. Billing is restricted to services delivered through this contract. The Contract does not handle billing for services outside of this contract such as insurance or private pay. Any unauthorized billing of examinees will be resolved within seven (7) business days of notification.

3.5.6. Accessibility Requirements (Section 508)

Section 508 of the Rehabilitation Act, as amended by the Workforce Investment Act of 1998 (P.L. 105-220) requires that when federal agencies develop, procure, maintain, or use electronic and information technology, they must ensure that it is accessible to people with disabilities. Federal employees and members of the public who have disabilities must have equal access to and use of information and data that is comparable to that enjoyed by non-disabled federal employees and members of the public. All deliverables within this work statement shall comply with the applicable technical and functional performance criteria of Section 508 unless exempt.

3.5.7 Access to Care Standards

Appointments shall be available during the normal network clinician business hours, including evenings and weekends, but shall not be expected to be offered 24/7. While appointments are not expected to be provided 24/7, the Contractor shall offer a clinician on call for any crisis situations that might arise. In addition, psychotherapy sessions are expected to be scheduled within five (5) business following initial contact by a client or once referral is received. If the Contractor is involved in crisis intervention involving a client and/or identifies immediate needs that require expedient response, an appointment will be provided within 24 hours. Appointments shall accommodate for time zones of the client’s location.

3.5.8 Hours of Operation

The Contractor shall be available 24-hours a day, 7-days a week, 365-days a year (24/7) for centralized and accessible call center operations. Call center operations will include the availability of a qualified clinician to consult on and handle crisis situations/calls.

The Contractor shall ensure that the administrative office is open 9:00 a.m. to 5:00 p.m. Eastern Time, Monday through Friday, exclusive of Federal holidays.

3.5.9 Quality Management Requirements

Quality elements of accessibility, timeliness, effectiveness, and reliability are key to promoting trust, credibility, and use of services amongst the wildland personnel. Therefore, it is critical that the Contractor provides and maintains a Quality Management Plan (QMP) that comprehensively describes and updates the methodology, processes, and protocols for accomplishing the tasks of this contract and integrates the Government’s requirements.

3.5.10 Informed Consent and Confidentiality

The Contractor shall have safeguards to ensure confidentiality and security of all psychotherapy and related files and information pertaining to the provision of services. Records are kept in a confidential manner in accordance with all applicable federal and state confidentiality laws, regulations, and guidelines including those pertaining to the confidentiality of alcohol and drug abuse patient records such as 42 C.F.R. Part 2, Confidentiality of Alcohol and Drug Abuse Patient Records, HIPAA, the Privacy Act of 1974, the National Archives and Records Administration General Records Schedule 1, and other applicable regulations and guidelines governing confidentiality of counseling and medical records.

Any utilization of personal records, medical records, transcripts, PHI/PII, use and utilization reports, or databases by the Contractor not expressly provided for in this document or superseded by a future document is expressly forbidden. The Contractor may not share or sell names, addresses, phone numbers, emails, or any other information, received in the execution of this effort, for any purpose unless expressly authorized in a written statement with approval from all parties.

Contractor staff and network clinicians shall provide informed consent information to all individuals seeking services during the initial therapy session. Information disclosed shall be kept confidential, except to meet legal obligations or to prevent harm to self or others. Psychotherapy notes are treated differently from other mental health information both because they contain particularly sensitive information and because they are the personal notes of the therapist that typically are not required or useful for treatment, payment, or health care operations purposes, other than by the mental health professional who created the notes. Therefore, with few exceptions, the Privacy Rule requires a covered entity to obtain a patient’s authorization prior to a disclosure of psychotherapy notes for any reason, including a disclosure for treatment purposes to a health care clinician other than the originator of the notes.

A notable exception exists for disclosures required by other law, such as for mandatory reporting of abuse, and mandatory “duty to warn” situations regarding threats of serious and imminent harm made by the patient (State laws vary as to whether such a warning is mandatory or permissible).

The Contractor may have access to sensitive and confidential business information in the possession of the Government for which the Government's right to use and disclose the data and information is restricted. Therefore, the Contractor agrees to abide by any restrictive use conditions on such data and sign a non-disclosure agreement. Employee services shall be confidential, with employee names omitted from billing and invoicing.

The Contractor is responsible for ensuring that the person to whom confidential information is released is notified of the prohibition on secondary disclosure of this information to another. The Contractor shall document this notification to the client record.

The exchange of client information between the…