Section C - Description_Specifications (Performance Work Statement).pdf

C - Description/Specifications

PERFORMANCE WORK STATEMENT (PWS)

Nurse and Vocational Rehabilitation Case Management Services (NVRS) Office of Workers' Compensation Programs (OWCP), Division of Federal Employees,' Longshore and Harbor

Workers’ Compensation

PART 1 GENERAL INFORMATION

1.1 Description of Services/Introduction

The Contractor shall provide all personnel, equipment, tools, materials, supervision, and other items and non-personal services necessary to provide Registered Nurse and Vocational Rehabilitation Counselors Case Managers for the Nurse Intervention Program and Vocational Rehabilitation Program for the Office of Workers' Compensation Programs (OWCP), Division of Federal Employees' Longshore and Harbor Workers’ Compensation (DFELHWC). Personnel, services, equipment, etc. shall be provided as defined in this Performance Work Statement (PWS), except as specified in section C-3 as Government furnished property, the Contractor shall perform to the standards in the resultant contract.

1.2 Background

The OWCP is responsible for the administration of the Federal Employees' Compensation Act (FECA). The FECA provides medical benefits, wage- loss replacement, survivors' annuities, and other benefits to employees of the United States or their survivors when the employee is injured or dies in the course of employment. The OWCP, through the Office of Workers' Compensation Programs (OWCP), Division of Federal Employees,' Longshore and Harbor Workers’ Compensation (DFELHWC), coordinates the FECA program. The FECA program currently has twelve offices around the country with staff directly responsible for processing and managing FECA claims. These staff, including Claims Examiners, oversee claims throughout the U.S. The FECA program functional operations include adjudicating incoming claims to determine eligibility for compensation payments;

managing claims in which eligibility has been established; determining wage-loss compensation payments for covered disability or death; and processing payments for allowed medical and vocational rehabilitation services incurred in the treatment of injured workers covered under the FECA.

The OWCP is also responsible for administration of the Longshore and Harbor Workers' Compensation Act (LHWCA).

The management of disability claims begins as soon as a new claim is received indicating that the employee has lost time from work as a result of the injury or is disabled from his or her date of injury position. The FECA Claims Examiner (CE) is responsible for the overall actions and directions throughout the disability management process; however, medical management, rehabilitation, and the return-to-work effort consist of more than just CE intervention. To further OWCP/FECA and LHWCA program goals and objectives related to disability management, the OWCP implemented two programs, as follows, which are administrated through the FECA Branch of Regulations and Procedures. The Nurse Intervention Program utilizes the services of the Contractor’s Registered Nurse Case Managers for two purposes: To assist with identifying cases that may benefit from more intensive and/or immediate intervention during the early part of the disability period; and to assist with medical management of claims. The Vocational Rehabilitation Program utilizes the services of the Contractor’s Rehabilitation Counselors to assist with the provision of vocational rehabilitation services.

1.2.1 The OWCP Nurse Intervention Program (NIP)

The OWCP is committed to seeing that benefits for compensation and medical services are appropriately and timely provided.

OWCP is also committed to assisting injured workers in obtaining a successful medical recovery and minimizing the period of disability from work. To that end, the program implemented Disability Management (DM) into claims processing through Quality Case Management (QCM). QCM is an initiative to intervene with injured workers (IW), employing agencies (EA), and medical providers as early as possible in the recovery process to assist in the facilitation of medical treatment plans and arrange for appropriate reemployment. The objectives of QCM are to take a series of purposeful actions to obtain medical care in a timely manner, to obtain timely work tolerance limitations, and to prevent cases from reaching the long-term disability roll; and has as its primary goal the medical recovery and reemployment of IWs who are in the beginning stages of disability.

To assist the CE in DM efforts, the OWCP incorporated the Nurse Intervention Program (NIP) into claims management. The OWCP NIP is an initiative to introduce the use of Contractor’s Registered Nurse Case Managers: Triage Registered Nurses (TN) and Field Nurses (FN). Introducing the use of Contractor’s FNs and TNs during the early stages of disability to facilitate expedited medical care and recovery which can result in shortening the length and extent of disability from work. The NIP is designed as a proactive, collaborative partnership between the Contractor’s TN and/or FN, the FECA claims staff, medical providers, RCs, the EA, and the IW.

FECA Staff Nurses (SN) oversee the NIP and act as a nursing resource and liaison for the claims staff, EAs, IWs, Contractor’s TNs, and FNs, and other OWCP stakeholders. The SN role is essential to establishing a cooperative, team approach to the DM process.

The SN is in a unique position to facilitate the interactions and open communications between the CE and nurse Case Managers, which is a key element to the overall success of the NIP.

In addition to acting as a nursing resource and liaison, the FECA SN is also responsible for administering the policies and procedures of the OWCP NIP. The SN coordinates the Contractor’s FN assignments; monitors the nurses’ performance in correlation to both the contract specifications and the quality of services provided; and reviews work products for quality, completeness, timeliness and approval for payment. The FECA SN role of monitoring work product quality is not a substitute for the supervision of Contractor staff. The Contractor is ultimately responsible for Contractor’s FN performance requirements including but not limited to training, quality of work product, compliance with policy, procedure, proactive cost-efficient FN case management actions and reporting requirements (to include monthly progress reports and interim communications).

In summary, Contractor RC's primarily communicate with the FECA RS. The FECA RS is the primary contact for the CE. The Contractor FN will regularly communicate with the CE by telephone or DMP upload of a memo. The FECA SN monitors cases and will contact the Contractor FN when necessary to follow up on reporting and critical timeframes. The Contractor FN can contact the FECA SN at any time as well via email or telephone. The CEs may contact the Contractor FN by email or telephone.

Any email correspondence must protect Personally Identifiable Information (PII) as directed under section 1.6.7 of this PWS. The SN will provide oversight of the program, but they are not supervisors, the Contractor shall be responsible for supervision of their own employees to ensure staff meets contract requirements. The SN will provide guidance and monitor contractor performance.

The OWCP has found that nurse intervention is an integral part of the overall disability management of a claim. The best outcomes stem from an active team approach where the FECA Program, the Contractor’s nurse Case Managers, the EA, the IW, and the medical providers use all available tools to facilitate medical recovery and a sustainable return to work. Nurse intervention has proven successful at achieving the primary objective and fulfilling the goals of the FECA program in returning the IW to the work force, thereby limiting lost time from work, and preventing work- related injury cases from unnecessarily reaching the long-term disability rolls.

1.2.2 The OWCP Triage Registered Nurse (TN) Program

The Triage Registered Nurse Program was developed to assist the program with prompt adjudication and payment of benefits, early intervention in traumatic injuries, active case management, and prompt/appropriate return to work.

The Contractor’s TN is a Registered Nurse Case Manager who provides short-term, telephonic triage services. TN interventions assist the CEs in prioritizing adjudication efforts and in identifying cases in need of Contractor’s FN case management.

1.2.3 The OWCP Field Nurse (FN)

The Contractor’s FN is a Registered Nurse Case Manager, assigned to work directly with FECA IWs either in person/face-to-face or telephonic only, who assists in the management of disability claims by utilizing and providing specialized nurse case management skills, techniques, and knowledge in the context of the workers' compensation arena. The Contractor’s FN provides a comprehensive nursing assessment of the IW’s anticipated duration of disability from work, abilities, needs, and concerns as they relate to the response to, and recovery from, a work injury; and in doing so, the Contractor’s FN then develops and implements a nursing case management plan to address those abilities, needs, and concerns. As part of this ongoing process, the Contractor’s FN evaluates the duration of disability from work and outcome of their interventions and makes necessary adjustments to the individual nurse case management plan as the IW's status changes throughout the Contractor’s FN phase of Disability Management (DM).

Early referral for Contractor’s FN intervention services is critical to ensuring successful DM. In person, or face-to-face Contractor’s FN intervention service, is recommended for more severe and/complex injury cases, in which, in person meetings with the IW, EA, and/or medical providers is beneficial in moving the case forward. In less complicated injury cases, the Contractor’s FN assignment may only require telephonic services.

FN assignment should occur as soon as possible after the injury occurs and the claim has been approved for a work-related injury.

FN assignment should occur if the IW has not returned to work. While early intervention is the primary focus, Contractor’s FN assignments may occur at any point during the life of a claim when needed. For example, FECA Medical Benefits Examiners (MBEs) may require Contractor’s FN assistance regarding medication management or in facilitating an IWs assessment/treatment for medication overuse, misuse, or addiction.

1.2.4 The OWCP Vocational Rehabilitation (VR) Program

The purpose of vocational rehabilitation within the FECA/ LHWCA program is to support IWs in returning to work. The primary goals of the program are to minimize the IW’s lost time from work due to disability and to facilitate a return to gainful employment, thereby assisting the IW to become productive and self-supporting and also reduce Employing Agency costs by eliminating or reducing workers' compensation payments.

The emphasis of the FECA/ LHWCA program's vocational rehabilitation program is the early referral and evaluation of all IWs who need services; effective case management to ensure that plans are efficient and of good quality; flexibility to provide the widest range of services from private and public rehabilitation agencies; preference for reemployment with the previous employer; and placement of IWs in jobs where disability does not prevent them from competing with non-disabled employees. The probability of effective rehabilitation resulting in the best return to work arrangement is greatly increased when such efforts begin as early as possible in the recovery process. As such, vocational rehabilitation may sometimes occur simultaneously with nurse intervention.

FECA/LHWCA CEs and Rehabilitation Specialists (RSs) carry out the vocational rehabilitation program with the assistance of Contractor’s Rehabilitation Counselors (RCs), private and public rehabilitation providers, physicians, and employers, so that eligible workers receive the rehabilitation services best designed to return them to suitable work, preferably with little or no loss of earnings. Under the FECA and LHWCA, both medical and vocational rehabilitation services can be funded in the return- to -work effort, as appropriate.

FECA/LHWCA program RSs serve as a rehabilitation resource and liaison for CEs, MBEs, nurses, EAs, IWs, and other stakeholders. In addition, the RS serves as the primary OWCP contact for the Contractor assigned RCs, administering the policies and procedures of the rehabilitation program, coordinating referrals, supervising case management, monitoring RC performance and reviewing and approving rehabilitation reports for completeness and timeliness. The RS role is essential to establishing a cooperative, team approach to the DM process. The RS is in a unique position to facilitate the interactions and open communications between the CE and RC, which is a key element to the overall success of the vocational rehabilitation program.

RCs are contracted to work directly with FECA/LHWCA program IWs in the field and to facilitate rehabilitation services and reemployment. Working in conjunction with the FECA program RSs, CEs, and MBEs, the Contractor’s RC assists in enhancing the efficiency and efficacy of the vocational rehabilitation program, supporting claims personnel in their efforts to meet program goals and objectives as they relate to return to work and minimizing lost time from work due to disability.

Reference the FECA/LHWCA Regulations and Standards:

https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FECA-PT8 https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FECA-PT7 https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FNHB-PT1 https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/RCHB/part1

Reference Attachment J- DMP Overview additional information regarding DOL Disability Management Portal (DMP).

1.3 Objectives

To provide nationwide Nurse and Vocational Rehabilitation Case Management Services for the Nurse Intervention Program and Vocational Rehabilitation Program for OWCP. To provide all the personnel, tools, and supervision as directed by this PWS throughout the period of performance.

1.4 Scope

The services provided by the Contractor shall support the OWCP, FECA and/or LHWCA programs in maintaining the integrity and success of each program and facilitate the IW’s recovery and return to work, wherever feasible, in accordance with 33 USC § 944, 5 U.S.C. 8103 and 8104.

This work involves the following:

1. Arrange for qualified and appropriate resources to make these services available for the FECA/LHWCA IW as provided in this PWS:1.6.8.

2. Ensure timely case management from assignment to closure of services within the timeframes and to the specifications as provided in this PWS including, but not limited to:

a. Contractor’s RC services as provided in Section 5.4 of this PWS. Contractor’s RC services are provided telephonic or in person/fact-to-face, depending upon the needs of the case. RC services include but are not limited to: Making timely contact and initiating vocational rehabilitation services with IWs; coordination of vocational testing, development of vocational rehabilitation plans and facilitation of medical and vocational rehabilitation services; assisting the IW and all stakeholders with return to work goals through reemployment with the previous EA or with a new employer; assisting FECA program staff with determinations regarding the IW’s wage earning capacity as needed; closing assignments as directed; confirming that appropriate authorization is received prior to provision of services; and ensuring delivery of services in accordance with FECA/LHWCA program regulations and standards for timeliness and quality.

b. Contractor’s FN services as provided in Section 5.5 of this PWS. Contractor’s FN case management services are provided telephonic or in person/face-to-face, depending upon the needs of the case. Services provided include but are not limited to: Making contact and initiating nurse case management services with the IWs.

Performing comprehensive nursing assessments and care plans to include anticipated duration of disability from work; obtaining medical records and documentation; facilitating and coordinating medical care/ needs with https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FECA-PT8 https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FECA-PT7 https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FNHB-PT1 https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/RCHB/part1 required contacts with the appropriate FECA staff, IW, EA, and medical provider(s), and OWCP’s Central Bill Processing (CBP) portal; completing FN interventions, activities, outcomes, and recommendations; identifying cases suitable for a referral for a Second Opinion medical examination and/or referral to the Vocational Rehabilitation program, and closing nurse case management services/assignments as directed. The FN shall also prepare cases for a referral for a Second Opinion medical examination upon request.

c. Contractor’s TN case management services as provided in Section 5.6 of this PWS. All Contractor’s TN services are telephonic only. Services include performing initial TN assignment actions; making required contacts with the IW, EA, and medical provider(s); and following closure protocols within the timeframes and to the specifications provided.

3. Assure provision of minimum IT requirements as described in 4.1 for use of the Government’s Current and all future IT systems, to include, but not limited to the FECA program’s Disability Management Portal (DMP), and OWCP’s Central Bill Processing (CBP) portal.

4. Assure timely delivery of all pertinent case documents supplied by the FECA/LHWCA program to Contractor’s RCs, FNs, and TNs as required by this PWS.

5. Assure timely submission of reports and other required documentation.

a. RC – 5.4 Task 3

b. FN – 5.5 Task 4

c. TN – 5.6 Task 5

6. Comply with applicable provisions of the Privacy Act of 1974 and otherwise assure the security and confidentiality of IWs’ medical records and related materials entrusted to the custody of the Contractor, RC, FN, and/or TN.

7. Assure timely, secure transmission of information to the FECA program of pertinent documents supplied by Contractor’s RCs, FNs, and/or TNs via DMP upload, with the exception of work products which are “Reports” and are submitted with associated billing/invoice to the approved bill pay portal. When imaged documents are not available for transmission via the secure web portal (primarily including medical records relevant to the assignment, etc.). Documents (other than work products which are “Reports” and are submitted with associated invoices/bills to the approved bill pay portal) can be uploaded via the Employees’ Compensation Operations and Management Portal (ECOMP). Any mode of transmission should ensure consistency with the Privacy Act of 1974.

All Services shall be provided for FECA/LHWCA IW per annum. Reference Technical Exhibit 3-Estimated Annual Data, Estimated Annual Number of Referrals and FTE and Monthly Workload Data. The affected IWs reside within the U.S. and the U.S territories. Case files are in the custody of the FECA/LHWCA Program. Access to the case files will be provided after award.

1.5 Period of Performance

The anticipated period of performance is one (1) base period and four (4) option period of 12-months each. The period of performance reads as follows:

Base Period: April 05, 2024- April 04, 2025 Option Period 1: April 05, 2025- April 04, 2026 Option Period 2: April 05, 2026- April 04, 2027 Option Period 3: April 05, 2027- April 04, 2028 Option Period 4: April 05, 2028- April 04, 2029

The Government reserves the right to extend the term of this contract at the prices set forth in Section B in accordance with the terms and conditions contained in clause 52.217-9 entitled, “Option to Extend the Term of the Contract”.

1.6 General Information

1.6.1 Quality Control (QC)

The Contractor shall develop and maintain an effective Quality Control Plan (QCP) to ensure services are performed in accordance with this PWS. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The Contractor’s QCP is the means by which the Contractor assures compliance with the requirements of the contract. As a minimum, the Contractor shall develop QCP that address the areas identified in Technical Exhibit 1, “Performance Requirements Summary”. The QCP shall be submitted to the Contracting Officer and Contracting Officer Representative (COR) within 30 calendar days of contract award. After acceptance of the QCP, the Contractor shall receive the Contracting officer’s acceptance in writing of any proposed change to his QCP.

1.6.2 Quality Assurance

The Government will monitor the Contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government must do to ensure that the Contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.6.3 Government Remedies

The Contracting Officer shall follow 52.246-4, “Inspection of Services-Fixed Price” for Contractor’s failure to perform satisfactory services, or failure to correct non-conforming services. The Contractor shall have the opportunity to correct such deficiencies within three (3) days or other agreed upon timeframe. Failure to correct the deficiencies within the agreed upon timeframe may result in breach of contract, a poor past performance rating documented in the Contractor Performance Assessment Reporting System (CPARS) and/or monetary penalties.

If the Contractor fails the monthly Acceptable Quality Levels (AQL) for the required work products described below, the Government may impose monetary penalties depending on the nature and impact of the infraction. The required work products that may incur in monetary penalties if significantly delayed are:

1. Triage Nurse Closure in DMP (in accordance with Section 5.6.4)

2. FN Report Regular (general initial, monthly or closure FN report) in accordance with Section 5.5.8.

3. FN Report Site Visit (general initial, monthly or closure FN report with an onsite/medical visit attended) in accordance with Section 5.5.8.

4. SECOP prep packet – Unit 1 per completed packet in accordance with Section 5.5.8.

5. RC Report Regular (general initial/monthly/closure RC report for VR placement services, training, or work monitoring) in accordance with Section 5.4.8.

6. RC Report Site Visit (general VR initial/monthly/closure RC report with an onsite visit) in accordance with Section

5.4.8.

7. RC Specialized Reports (as designated by FECA templates provided, such as, Plan Development) in accordance with

Section 5.4.8.

A significant delayed submission regarding the above work products will result in a monetary impact to the Government. A significant delay for the above work products is defined as 30 calendar days after the originally agreed upon timeframe of submission. Per the impact to the Government, the Contractor may receive a monetary penalty of 25% reduction to the work product’s associated fixed payment amount after 30 calendar days a work product/ report and the respective invoice remains uncorrected and unsubmitted. An additional 15% reduction (40% total) may be applied for work products received between 31-60 calendar days. An additional 10% reduction (50% total) may be applied for work products received between 61-180 calendar days.

Reports received after 180 days will not receive any payment.

For instance, the Contractor shall submit a FN Report Regular and respective invoice for case number 0001 monthly until the case is closed. If the FN Report Regular and respective invoice is submitted on-time and accurately, the Contractor shall receive the approved fixed payment amount for the respective work product and associated billing code (i.e., NIP001) through OWCP’s Central Bill Processing (CBP) portal or equivalent. If there are any deficiencies/ issues identified by the Government with the particular FN Report Regular and respective invoice, the Contractor shall correct it within three (3) business days or an agreed upon timeframe. If the particular FN Report Regular and the respective invoice is corrected and submitted within the agreed upon timeframe, the Contractor shall receive the approved fixed payment amount for the respective work product and associated billing code (i.e., NIP001). However, if the penalty is imposed by the Government after a significant failure of the AQL for FN Regular Reports, and the Contractor does not correct the particular FN Report Regular and the respective invoice within agreed upon timeframe, then the Contractor may receive a monetary penalty of $100.00 after 30 calendar days a work product/ report and the respective invoice remains uncorrected and unsubmitted. In this scenario, if the fixed approved payment rate for NIP001 is $500, the payment to the Contractor will be as follows: $500 if the particular FN Report Regular and the respective invoice is submitted monthly on time and accurately; $500 if the particular FN Report Regular and the respective invoice is corrected within the agreed upon timeframe; $375 (25% reduction of $500) after a penalty is imposed by the Government due to non-compliance with the respective AQL and if the particular FN Report Regular and the respective invoice is submitted 30 calendar days late; $300 (40% reduction of $500) after a penalty is imposed by the Government due to non-compliance with the respective AQL and if the particular FN Report Regular and the respective invoice is submitted 31-60 calendar days late; $250 (50% reduction of $500) after a penalty is imposed by the Government due to non-compliance with the respective AQL and if the particular FN Report Regular and the respective invoice is submitted 61-180 calendar days late. Reports received after 180 days will not receive any payment.

Reference Technical Exhibit 1- Performance Requirement Summary for AQL information.

The Government shall use positive past performance ratings documented in CPARS as incentives. Incentives shall be based on exceeding, meeting, or not meeting performance standards.

1.6.4 Recognized Holidays

The Contractor is not required to perform services on the following holidays:

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day

President’s Day Veteran’s Day Memorial Day Thanksgiving Day Juneteenth Day Christmas Day Independence Day

Or any other day designated by Federal Statute, Executive Order, or Presidential Proclamation. Reference the U.S. Office of Personnel Management (OPM) for the most recent information on approved Federal Holidays: https://www.opm.gov/policy-dataoversight/pay-leave/federal-holidays/#url=Overview.

Any of the above holidays falling on a Saturday or Sunday shall be observed on the date designated by the Federal Government.

Observance of such days by Government personnel shall not be cause for additional period of performance or entitlement to compensation. If the Contractor’s personnel work on a holiday, the Government will not reimburse the contractor for holiday premium pay or other premium compensation.

1.6.5 Hours of Operation

Contractor’s RC, FN, and TN shall establish their own hours as necessary to meet the Government’s requirements. The Contractor is responsible for providing contract case management and administration services between the hours of 8:00 am to 5:00 pm EST, Monday thru Friday except Federal holidays or when the Government is closed due to local or national emergencies.

An emergency contact person shall be provided for FECA contract management in the event that communication is necessary after business hours or on weekends. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.6.6 Place of Performance

The work is to be performed throughout the United States, its possessions, territories, and trust territories. No contract staff will work in an OWCP location. The contract staff will work where the Contractor is located or in a location designated by the contractor.

The Contractor’s RCs and FNs must be available in sufficient numbers and geographically distributed as to cover IWs nationwide (including US Territories). Every effort should be made to assign a Contractor’s FN/RC within reasonable proximity to the community in which the IW resides to ensure the Contractor’s FN/RC is familiar with medical and vocational services and providers available in the area, as well as be able to provide in-person services should the need arise without a need to reassign the case to a new FN/RC. The FECA program considers a reasonable commuting distance to be within 50 miles one way to the community in which the IW resides.

Although FN/RC assignments are primarily telephonic and/or virtual, depending upon the needs of the case there may be a situation which requires an onsite visit. Therefore, it is important that the FN/RC is located within a reasonable proximity to the IW.

RCs/FNs should be within a reasonable proximity to the IW whether telephonic or in person assignment. When the IW lives in a rural area the proximity to the IW may exceed the normal commuting distance requirement.

Note: Contractor’s TNs shall be provided in sufficient numbers to cover the services required and each associated task. In addition, TN services are telephonic only and prospective vendors shall only ensure places of performance are consistent with nurse licensing strictures.

** Medical professionals providing services for the NVRS requirement will be subject to the licensing requirements of the state(s) in which they are performing services. For example, if a Nurse intends to provide services in Florida and Kentucky, then the Nurse is required to meet the licensing standards of Florida and Kentucky. A FN compact license is acceptable. However, the provisions in this Section still apply. Every effort should be made to assign a Contractor’s FN/RC within reasonable proximity to the community in which the IW resides to ensure the Contractor’s FN/RC is familiar with medical and vocational services and providers available in the area, as well as be able to provide in-person services should the need arise without a need to reassign the case to a new FN/RC.

1.6.7 Security Requirements

Contractor personnel are required to conform to DOL's security and privacy requirements as described below:

1.6.7.1 Security Documentation

The Contractor shall comply with the Computer Security Act of 1987. All products and deliverables developed under this PWS shall comply with DOL Computer Security guidelines and the guidelines contained in OMB Circular A-130. All Contract staff using the DOL LAN/WAN and computer systems to perform duties under this PWS will agree to and sign the GSS Rules of Behavior for Computer Use, Major Application Rule of Behavior and a Non-Disclosure Agreement. A copy of each signed and witnessed non-Disclosure agreement shall be submitted to the Contracting Officer (CO) prior to the employee performing any work https://www.opm.gov/policy-dataoversight/pay-leave/federal-holidays/#url=Overview https://www.opm.gov/policy-dataoversight/pay-leave/federal-holidays/#url=Overview under the contract. All Contractors must receive security awareness training prior to being given access to DOL systems and at least annually thereafter as required by DOL security policies.

The Contractor shall comply with the Federal information security standards. The Federal information security guidelines include, but are not limited to, the following:

1. OMB Memorandum M-07-16, Safeguarding Against and Responding to the Breach of Personally Identifiable Information, May 22, 2007.

2. OMB Memorandum M-06-19, Reporting Incidents Involving Personally Identifiable Information and Incorporating the Cost for Security in Agency Information Technology Investments, July 12, 2006.

3. OMB Memorandum M-06-16, Protection of Sensitive Agency Information, June 23, 2006.

4. OMB Memorandum M-06-15, Safeguarding Personally Identifiable Information, May 22, 2006.

5. Federal Information Processing Standards Publication (FIPS) PUB 140-2, Security Requirements for Cryptographic

Modules, May 25, 2001.

6. DLMS 9 – Chapter 1200 “Safeguarding Sensitive Data Including Personally Identifiable Information.” To be provided as

GFI.

1.6.7.2 User Accounts for Government IT systems

The Contractor shall ensure that the proper user account forms are completed and submitted to the FECA program for all contract users needing access to the DOL systems. Such paperwork is needed for access to the Government’s current and future IT systems, to include but not limited to, FECA’s DMP, and OWCP’s CBP portal. The specific forms will be provided to the Contractor after award.

The Contractor shall maintain user account request forms and security documentation review documents. Upon 7 days of contract personnel resignation, dismissal or reassignment, the contract Project Manager shall notify the COR/FECA Program Management.

On the day of employment termination all necessary account deletion forms must be filled out and made available to OWCP (within 24 hours). When applicable, the Contractor must also take direct steps to disallow a transferred or terminated user’s access to DOL systems immediately. The Contractor shall review information system accounts every 6 months to also include the matching of user accounts with relevant user records (including, but not limited to, personnel files) to ensure that terminated or transferred individuals do not retain system access. The annual recertification of accounts must be a full review of all user accounts.

1.6.7.3 Background Investigations

The Contractor shall conduct background investigations on all personnel assigned to this contract. The background investigations shall comply with applicable agency personal identity verification procedures, Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

1.6.7.4 Privacy and Reasonable Accommodation

Information relating to individual claims of Federal employees for benefits under the Federal Employees' Compensation Act (FECA) is maintained in the Privacy Act System of Records entitled DOL/GOVT-1. Information from the DOL/GOVT-1 system of records is protected by the provisions of the Privacy Act of 1974; therefore, all personnel assigned to this contract shall take proper precautions to protect the information from disclosure. All personnel assigned to this contract are responsible for protecting this Privacy Act information in the same way, and to the same extent, as Federal employees (including criminal penalties for improper disclosure). Additionally, all personnel assigned to this contract must take an online training course for handling Personally Identifiable Information (PII). This course is required before system access is granted and then must be completed annually by all employees (including Contractor employees) with access to DOL systems. Contractors will include in this online training information about reasonable accommodation in the FECA claims process including communication assistance to hearing and visually impaired IWs. Reference FECA Bulletin 12-05 for more information:

https://www.dol.gov/sites/dolgov/files/owcp/dfec/regs/compliance/12-05AccommodationsBulletin-Signed%20Copy.pdf

1.6.7.5 Ownership

All products and deliverables developed under this PWS are the property of the U.S. Government and DOL. The Contractor may not change, modify, or use any materials developed under this PWS outside the scope of this contract without the Government’s approval.

1.6.7.6 Commitment to Protect Sensitive Information

The Contractor shall not release, publish, or disclose sensitive information to unauthorized personnel, and shall protect such information in accordance with provisions of the following laws and any other pertinent laws and regulations governing the confidentiality of sensitive information: 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records).

https://www.dol.gov/sites/dolgov/files/owcp/dfec/regs/compliance/12-05AccommodationsBulletin-Signed%20Copy.pdf

The Contractor agrees that only persons authorized by the Government shall access and/or utilize the Government’s current and future IT systems, including but not limited to DMP, and/or CBP portal.

During the performance of this contract the Contractor will come into contact with proprietary Government information (i.e., Financial/accounting records) or sensitive information. With respect to any such information obtained in the course of the performance of this Task where such effort may reasonably lead to an employee having access to this information, and when specified in a delivery order, the Contractor agrees as follows:

1. Not to use such information for any purpose other than in the performance of the contract.

2. To limit access to such Government information to those in Contractor’s employment who are actually performing work on the task and need to know in order to perform the services under this contract.

1.6.7.7 Disposition of Sensitive Documentation

The individual FN and RC must not retain case-specific personal information or documents pertaining to a FECA/LHWCA case after closure of the case. The individual FN and RC are required to document in their final report and/or certify in DMP (currently only in TN cases) the disposition of all OWCP case file information, materials, medical records, and/or emails that may exist in any form (hard copy and/or electronic). This includes documenting the means by which this action was performed, e.g., permanently deleting, shredding, or burning. Upon termination of employment, in addition to above, the FN/RC/TN must provide a signed letter to the Contractor verifying the disposition of all OWCP case file information, materials, medical records, and/or emails that may exist in any form (hard copy and/or electronic) in their possession. This includes documenting the means by which this action was performed, e.g., permanently deleting, shredding, or burning. The contractor is required to maintain a copy of letter(s) on all outgoing employees and provide copies upon the Government’s request. If the Contractor’s FN/RC/TN fails to produce final letter verifying disposition of case file materials; the Contractor will notify the COR. The Contractor will assist in any follow up actions as needed to ensure security and final disposition of case file materials.

1.6.7.8 PII Breach

In accordance with this PWS and with the applicable PII contract clause (Privacy Breach Notification Requirements), the Contractor shall be responsible for reporting any breach or suspected breach of PII data within one (1) hour of becoming aware of the incident. PII is defined as any and all documents or electronic records containing information of a personal nature, which can be searched or retrieved, by name, social security number or other personal identifying designation.

Any failure to provide data protection and/or timely notification of a breach may result in the assessment of negative incentives by the Government. The Contractor shall notify the designated points of contact immediately via whatever means (e.g., phone call, email, etc.) which satisfactorily accomplishes this requirement. Thereafter, the Contractor shall confirm the breach and gather all necessary facts to complete the Government-provided Incident Report form to notify the Government of all details of the security incident involving PII. Incident Report form will be provided after award.

In the event of a suspected, potential or PII breach, the Contractor shall notify within one (1) hour of the breach:

zzOWCPSECURITY@dol.gov

If E-mail is not possible then please notify: (To be provided after contract award)

As additional information becomes known, the Contractor shall update the Incident Report form and resend to the e-mail group above. Once the DOL receives the Incident Report, someone within the OWCP will review the report to make a determination if there was a breach. In the event of a breach, the Contractor is not to notify the injured workers and/or their authorized representatives. The Government will perform that notification.

1.6.7.9 Removing Employees for Misconduct and Security Reasons

The Government reserves the right to request the Contractor remove contractor employees from any work within the scope of this contract for gross misconduct or security reasons (i.e., conflict of interest, etc.). The Contracting Officer will notify the Contractor of all violations and the Contractor will be responsible for removing from case work and replacing those persons immediately, but no later than five (5) days upon notification. Removal of a Contractor employee from work within the scope of this contract does not relieve the Contractor of the responsibility to continue to provide all services required under the awarded contract. The COR in coordination with the Federal Program Manager (reference Section 1.6.12) will provide the Contracting Officer with a written explanation to support any request to remove and/or replace an employee or Subcontractor prior to submission to the Contractor.

The Contractor shall be responsible for safeguarding all Government property provided for contractor use. At the close of each work period, Government facilities, equipment, and materials shall be secured.

1.6.8 Special Qualifications

1.6.8.1 Contract Manager

The Contractor shall provide a Contract Manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the Contracting Officer. The Contract Manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The Contractor shall provide the resume of the Contract Manager to the COR for review and approval prior to hiring/assignment to this contract.

General Experience: A minimum of five (5) years of experience providing program management services to organization management and technical staff in overseeing similar nursing and/or vocational rehabilitation services and similar to the administration of projects of the type called for in this requirement. Knowledge of the general principles of OWCP FECA laws and program is preferred. Excellent verbal and written communication skills and leadership skills is advantageous. Proven ability to meet schedule and performance requirements for programs of a similar size and scope is required. Thorough knowledge of Government contract management is preferred.

Duties:

1. Oversees all company operations to ensure the success of the contract and DOL Program.

2. Authority to implement contract and program changes.

3. Responsible for determining required resources and skills for performing contract tasks in an effective manner.

4. Responsible for managing and tasking contract staff.

5. Responsible for monitoring financial and fiscal aspects of the contract.

6. Coordinates and manages all contract operational activities including staff assignments, staffing, resource identification, documentation of task activities, and reporting to the Government COR.

7. Troubleshoots issues and concerns expressed by the Government COR and facilitates resolution and timely correction.

8. Coordinates work schedules and prioritizes tasks.

9. Manages the financial aspects of the contract and continuously reviews task progress and execution.

10. Researches, develops, and implements ideas and procedures for improving work efficiency and quality.

11. Manages employee performance and initiates personnel changes.

12. Recruits and develops other staff members (as necessary).

1.6.8.2 Quality Control Analyst

The Government anticipates that multiple Quality Control Analysts (QCA) will be necessary to adequately monitor all of the services required by this PWS. The Contractor shall provide the resume of the QCA to the COR for review and approval prior to hiring/assignment to this contract.

General Experience: At a minimum, the QCA shall have a minimum of five (5) years of Quality Control knowledge and experience providing and overseeing similar tasks identified in this requirement.

The QCA shall have the ability to ensure quality deliverables in accordance with the PWS, and to ensure that all required performance standards are met. Knowledge of Federal workers’ compensation laws, regulations, and processes is preferred.

Experience with nursing and/or vocational rehabilitation case management in the FECA or other workers compensation arena is preferred. A proven track record in meeting deliverable schedules and performance requirements for programs of a similar size and scope is required.

Duties:

1. Provides day-to-day oversight in order to ensure quality control measures are adhered to support:

a. All vocational rehabilitation and/or nursing related services including scheduling, reports, appropriate case actions, cost effective services and billing charges etc.

b. Collaborate with the Contract’s Trainer and the FECA program to include lessons learned from quality assurance findings or corrective actions into the training materials.

c. Ensures all cases are assigned and serviced timely; ensures when case reassignment is required, FECA is notified of the request for reassignment to a new Contractor’s FN/RC, verification of destruction of PII has been received, and that FECA has approved the reassignment to a new Contractor’s FN/RC.

d. Ensures access to DMP and central bill pay portal, and any equivalent thereof.

e. Ensures compliance with OWCP Records Management policies.

f. Ensures compliance with Privacy Act of 1974 and all other requirements of the PWS.

g. Ensures timely transmittal of all materials, and destruction of all materials when assignment ends.

h. Other specific tasks that may be added.

2. Monitors the day-to-day activities as follows:

a. Assigns and schedules work projects.

b. Schedules special and non-routine functions.

c. Monitors day-to-day projects to ensure work completion in accordance with established timeframes.

d. Establishes priorities for projects.

e. Assures the quality, quantity, and accuracy of work performed.

f. Assists in recruiting and screening of qualified Contractor’s RC, FN or TN Nurses.

g. Trains and monitors the progress of contract staff assigned to the specific task.

h. Assists the Contract Manager in development of corrective action plans, assessing training needs, and potential personnel actions, and other activities as directed.

i. Acts on behalf of the Contract Manager when they are on leave or assigned to other temporary activities; and

j. Verifies the accuracy, quality of services, and cost effectiveness of all paid services and addresses irregular reporting practices.

1.6.8.3 Trainer and Subject Matter Expert

General Experience: At a minimum, the trainer shall be a subject matter expert and shall have four (4) years of demonstrated ability in leading or training others as a nurse Case Manager, vocational rehabilitation counselor, or in a workers’ compensation claims environment, with a preference for Federal Government program experience. Demonstrated experience creating and implementing training and competency plans is preferred.

The trainer shall have the ability to assess training needs, create and utilize training tools and materials provided or approved by FECA, and test (or measure) for required competencies. The trainer shall have the ability to ensure that the training reflects an understanding of FECA regulations, policy, procedure, and processes, pertaining to the nurse and vocational rehabilitation programs, contributing to quality deliverables in accordance with the PWS, and helping to ensure that all required performance standards are met.

Knowledge of Federal workers’ compensation is preferred. Experience with nursing and/or vocational rehabilitation case management in the FECA or other workers compensation arena is preferred. Knowledge of FECA policy, procedures and requirements, as outlined in the FECA Procedure Manual, Field Nurse Handbook and Vocational Rehabilitation Counselor Handbook.

Duties: The trainer shall provide initial and ongoing training to FN/RC’s utilizing training materials that have been provided or approved by the Federal Program Managers and serve as the point of contract for routine procedure and process questions.

Following initial training, the trainer administers a FECA knowledge assessment provided or approved by the FECA Federal Program Managers and ensures the Contract’s FN/RCs completion of training and competent to work FECA cases. Results of the assessments are retained by the Contractor for a minimum of 1 year. The trainer is responsible for escalation to FECA Program Management and/or RS/SN’s when technical or case specific direction is required. The trainer:

1. Evaluates Contractor performance data to identify group and/or individual training needs on an ongoing basis.

2. Ensure all Contractor FN/RC’s receive appropriate training when there are policy and procedural changes.

3. Prepare and conduct corrective action training when it is determined to be necessary.

4. Prepare and administer a FECA knowledge assessment to establish FN/RC competency prior to beginning case assignments.

5. Organize and prepare training materials and/or educational programs for Contractor FNs and RCs, utilizing information and training materials provided by and/or approved by FECA.

6. Works with the Contract Manager, QCA and Federal Program Managers, to…