Amendment_000001_Attachments.pdf

SECTION B – SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 Purpose of Contract

The purpose of this procurement is to provide on-site technical assistance to eight (8) small rural hospitals. The technical assistance services shall prepare the eight (8) small rural hospitals for transitioning to in a new health care environment. The contractor shall support the development of a toolkit, which will incorporate feedback from the technical assistance provided, that will inform rural communities of tested strategies in preparing for the new health care environment.

B.2 Compensation Cost/Price

1. In consideration of the satisfactory performance of the services and tasks detailed in Section J–

Attachment A-Statement of Work, the Contractor shall be compensated in accordance with the following amounts:

a) Base Period September 30, 2014 – September 29, 2015

The price to the Government for full performance of the base period under this contract will be

b) Option Period One September 30, 2015 – September 29, 2016

The price to the Government for full performance of Option Period One, if exercised, under this contract will be $_________.

2. The total Firm Fixed Price (FFP) for the Base Period and the Option Period One (1) is $___________.

*At time of award, the award can be funded per fiscal year or by 3 month intervals depending on budget constraints.

F.6 Schedule of Deliverables

a. The Contractor shall submit all items in the quantities and by the dates indicated to the COR.

(Base and Option Periods)

TASK DELIEVERABLES QUANTITY DUE DATE

1.2 Draft agenda 1 Three (3) days from EDOC

1.3 Final agenda 1 One (1) day prior to initial

meeting.

2.1 Draft outreach plan 1 Four weeks (4) of EDOC

2.2 Final outreach plan 1 One (1) week from the task

2.1

3.4 Draft application and

process

1 Six (6) weeks from the EDOC

3.5 Final application and

process

1 Three (3) days of 3.4

3.6 Ranked-order list 1 Within eight (8) weeks of 3.5

4.1 Technical assistance

plan

1 Within three (3) weeks of 3.6

5.1 Draft toolkit report 1 Eleven (11) months from the

EDOC

5.2 Final toolkit 1 One (1) week of 5.1

6.1

Monthly Conference call Schedule

Within three (3) days of kick-off conference call

6.2 Draft monthly call

agenda

1 Two (2) days prior to each call

6.3 Final monthly call

agenda

1 One (1) day prior to conference call

6.4 Progress report 1 Quarterly

6.5 Consultation

summaries

As completed Quarterly

SECTION 508 GPAT DELIVERABLES

HHS Section 508

Product Assessment

Template

HHSAR 352.239-73 (c) –

Electronic and Information

Technology Accessibility One

See Task Order

Proposal Instructions

Section 508 Annual

Report

HHSAR 352.239-73 (c) –

Electronic and Information

Technology Accessibility One

End of each contract year

In addition to the number of copies to be submitted as shown above, one copy of the final report shall be mailed directly to:

Health Resources and Services Administration

Attn: Contracts Office

5600 Fishers Lane, Room 14W25C

Rockville, Maryland 20857

b. Reporting Requirements And Deliverables

1. The contractor shall submit the items in quantities and during the time periods indicated above to the following address:

Health Resources and Services Administration

Attn: COR

5600 Fishers Lane, Room 14W25C

Rockville, Maryland 20857

2. The Contractor shall deliver all items labeled per instructions, and in the quantity cited, and at the time indicated or before the time indicated in this Article.

a. All deliverable reports are to carry at the top of the first page the following information:

1) Contract number

2) Deliverable item number

3) Deliverable item delivery due date

4) Date of submission

b. All deliverables are subject to the review and approval of the COR.

ATTACHMENT A - STATEMENT OF WORK

Statement of Work August 13, 2014

Project Title: Small Rural Hospital Transition Project (SRHT)

I. Background

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (ORHP) is the focal point for rural health activity within the U.S. Department of Health and Human Services (HHS). The Office is charged in Section 711 of the Social Security Act with advising the Secretary of HHS on the effect of regulatory policy on rural communities and with ensuring access to health care services in rural communities through a variety of programmatic and policy activities. Through policy development, technical assistance, grant making and advocacy, HRSA's ORHP seeks to improve access to health care for the 60 million people who live in rural America.

Under Section 330A of the Public Health Service Act [(Public Law 42 U.S.C. 254 c (E)] ORHP funds grant programs supporting expanding access to, coordinating, restraining the cost of, and improving the quality of essential health care services in rural and frontier communities.

Small rural hospitals are facing many challenges in the new health care environment, including the concurrent need to better measure and account for quality of care in all settings and improve transitions of care as patients move from one care setting to another, the evolution of new payment approaches such as value-based purchasing, and new approaches to care delivery such as accountable care organizations (ACO) and patient-centered medical home.

Success in this new environment will require bridging the gaps between the current health care system and the newly emerging system of healthcare delivery and payment. Also, because little is known about how these new models might impact rural communities, there is a need to help hospitals understand and consider those factors that would make them logical participants in health care systems that focus on value. This contract, also funded by Section 330A, will support the Small Rural Hospital Transition (SRHT) project to assist small rural hospitals with fewer than 50 staffed beds with facing these challenges. ORHP anticipates that current and former Section 330A grantees will be among those receiving assistance under this contract.

II. Purpose

The purpose of this procurement is to provide on-site technical assistance to eight (8) small rural hospitals. The technical assistance services shall prepare eight (8) small rural hospitals for transitioning to the new health care environment. Eligible hospitals will reside in persistent poverty areas. The contractor shall support the development of a toolkit, which will incorporate feedback from the technical assistance provided, that will inform rural communities of tested strategies in preparing for the new health care environment.

III. Period of Performance

The period of performance shall be for a base period of twelve (12) months with one (1), twelve

(12) month option period.

IV. Tasks

Task 1: Initial Meeting

The contractor shall:

1.1 Participate in an initial meeting with the COR via conference call within one (1) week from the EDOC, to discuss the scope of work and the schedule of deliverables.

1.2 Create and submit a draft copy of the conference call agenda for the monthly PO call to the COR within three (3) days prior to the initial meeting for review and approval. The approved agenda shall be submitted to the COR one (1) day prior to task 1.1.

Task 2: Develop & Implement Outreach Plan

2.1 Develop and execute an outreach plan for eligible small rural hospitals with the maximum of 49 staffed beds. The outreach plan shall inform eligible hospitals of the Small Rural Hospitals Transition (SRHT) project and of qualifications for eligibility. The outreach plan shall also include a strategy for promoting the project among rural stakeholders. A draft copy of the outreach plan shall be submitted to the COR for review and approval within four (4) weeks of EDOC.

The outreach plan shall include the following information:

a. Criteria to determine hospital eligibility, a preference statement in consideration of hospitals located in persistent poverty areas (List of hospitals will be provided by

COR), and criteria to determine hospitals’ readiness or ability implement consultants’ recommendations from the onsite technical assistance.

b. Explanation of the communications efforts and key messaging strategies to be employed by the contractor in promoting the project among rural stakeholders and in targeting small rural hospitals, including recipients of funding under HRSA’s

Network Development program and the Small Health Care Provider Quality

Program must also be included in the plan.

2.2 Submit to the COR the approved outreach plan within one (1) week from task 2.1.

Task 3: TA Service Selection

3.1 Support the provision of the technical assistance to assist the small rural hospitals in developing a comprehensive plan for implementing strategies for change in the following core areas. Technical assistance activities shall focus on approaches which assist hospitals in bridging the gaps between the current health care system and the newly emerging system of healthcare delivery and payment.

The core areas shall include:

a. Financial Assessments - Improve key financial ratios and profitability, such as, improvements in days in accounts receivable, days cash on hand, total margin, operating margin, debt service coverage, salaries to net patient revenue, Medicare inpatient payor mix, average age of plant years, long term debt to capitalization, total margin, total revenue, and days of cash on hand.

b. Creating a Quality-Focused Environment - Activities to improve patient care and operations that are related to rural relevant measures.

c. Aligning Services to Community Need - Meeting local clinical need in an economically viable manner.

d. To the extent that financial and quality core areas have been stabilized, provide assistance to help recipients of technical assistance consider factors that would make them logical participants in health care systems that focus on value (for example ACOs, shared savings programs, primary care medical homes).

3.2 Develop a process for developing, receiving, reviewing, and scoring hospital applications for participation in the SRHT project. The application scoring process shall incorporate a preference statement giving consideration to hospital applicants located in persistent poverty areas.

3.3 Develop an application form to be completed by small rural hospitals. The application form shall include a self-certification statement to verify that the hospital is not currently receiving federal funds to support the activities supported by the SRHT project. The application process shall support the selection of eight (8) small rural hospitals to receive on-site technical assistance.

3.4 Submit to the COR draft copy of the application process and form for review and approval within six (6) weeks from EDOC.

3.5 The final application process and application form shall be submitted to the COR within three (3) days of Task 3.4 for approval.

3.6 Submit a ranked-order list of hospitals selected to receive technical assistance based on program eligibility, readiness, selection criteria, and preference statement to the COR for review and approval within eight (8) weeks of 3.5. Any additions and/or deletions from the eligibility list are subject to COR approval.

Task 4: Technical Assistance

4.1 Develop and submit to the COR, an on-site technical assistance (TA) plan within three (3) weeks of 3.6. The on-site TA plan shall include the following information: hospital name and location, type of technical assistance requested by core area, project goals and objectives, anticipated outcomes and measures, consultant’s name, dates of on-site technical assistance, and project completion date. The schedule shall be designed in spreadsheet format. Any subsequent changes to the on-site TA schedule shall necessitate the submission of a revised schedule to the COR and should include the date of revision.

4.2 Plan, coordinate, facilitate, and participate in a maximum of two (2) on-site technical assistance visits for each of the eight (8) hospitals participating in the project, for a total of up to sixteen on-site technical assistance visits per year. Each site visit shall be no more than two (2) days in length. Technical assistance shall encompass the following activities:

developing strategies in response to challenges faced by small rural hospitals preparing for the new health care environment, pre on-site planning, setting mutually agreed upon goals and objectives, action planning, developing measurable outcomes, coaching as the hospital implements recommended activities, and writing the consultant’s summary of the project. To link hospitals up with additional resources, consultants will have in-depth knowledge of ORHP programs and guide hospitals in using various 330A grants, tools, and resources to help navigate through the transition.

4.3 Develop and submit to the COR a consultation summary for each of the eight completed on-site technical assistance visit that occurred during the quarter. The consultation summary will describe the following: brief hospital background, requested technical assistance by core area, purpose of technical assistance, project goals and objectives, including prescribed strategies and tactics to meet goals and objectives, challenges, anticipated outcomes and measures, findings from any assessments completed as part of technical assistance, consultants’ recommendations, any additional information deemed relevant by consultant, hospital name including city, state, parish or county, hospital ownership type, number of staffed beds per the Medicare Cost Report, Critical Access

Hospital (CAH) status, dates of on-site technical assistance, consultant name.

a. The consultation summary shall be designed in a standard format and utilized by all consultants.

b. The consultation summary shall be included as an appendix in the quarterly reports to the COR.

Task 5: Toolkit

5.1 Develop and submit a toolkit incorporating feedback from the technical assistance provided, which shall be adaptable for use by other small rural hospitals in rural communities. A draft copy of the toolkit shall be submitted to the COR for review and approval eleven (11) months from the EDOC. All comments and edits of the draft toolkit report shall be in track changes format.

5.2 The final approved toolkit report shall be submitted to the COR one (1) week from the draft copy.

The toolkit report shall:

a. 508 compliant and compatible with the GPO, HHS, and HRSA writing and publications guidelines for posting to the Rural Community Health Gateway, http://www.raconline.org/communityhealth/, one of ORHP’s national clearinghouses.

b. Grammatically corrected and error free.

Task 6: Reports

6.1 Submit to the COR via electronic media, a schedule of monthly conference calls within three (3) weeks from the EDOC. The conference calls shall provide the COR with updates on all facets of the project.

6.2 Via electronic media, submit to the COR for approval, a draft agenda for each monthly conference call two (2) days prior to each call.

6.3 The approved agenda shall be submitted to the COR one (1) day prior to the conference call.

6.4 Prepare and submit to the COR a quarterly progress report, which shall include a summary of the tasks, all major program activity and accomplishments, challenges and solutions, upcoming activities, as well as, an accounting of administrative costs and the total cost for each on-site consultation for the quarter,

6.5 Prepare and submit to the COR a consultation summary of each on-site technical assistance completed during the quarter. The consultation summaries shall be included as an appendix in the quarterly reports (See Task 4.3).

V. Payment Schedule

The contractor shall submit a monthly invoice for payment on the 15th of each month, based on the completion of requirements in accordance with the statement of work.