Section_J_Attachments.pdf

19-250-SOL-00033

Section J, Attachment A

Technical Assistance (TA) IDIQ Statement of Work (SOW)

Date: March 29, 2019

I. Background

The Health Resources and Services Administration (HRSA) is an agency of the U.S. Department of Health and Human Services (HHS) and is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable. The mission of HRSA is to improve health and achieve health equity through access to quality health services, a skilled health workforce and innovative programs. HRSA’s programs assure the availability of quality health care to low income, uninsured, isolated, vulnerable and special needs populations. HRSA funds more than $7 billion in Federal awards on an annual basis.

These awards are administered by various programs that work in synergy to improve access to care for the more than 28.5 million Americans who are uninsured of those 40 million Americans who live in medically underserved areas. Likewise, almost 4 million uninsured Americans live in non-metro/rural areas. In fiscal year 2018, over 1,000 of HRSA’s grantees included telehealth as a way of improving access to care. The selection of the best award recipients, HRSA’s monitoring and regular assessment of their performance against program requirements and standards, along with the quick deployment of TA measures to support performance improvements, are key factors to assuring HRSA’s success with consistently realizing its strategic goals missions.

HRSA understands that the demonstrated compliance with program requirements, by program participants is key to the long-term success of each program and the Agency. HRSA is committed to recruiting and developing the highest functioning federal workforce, which collectively supports a culture of continuous quality improvement through innovation. As such, HRSA invest in a variety of developmental, operational, and consultative TA services for its program stakeholders and federal partners.

II. Purpose / General Description

The purpose of this Indefinite-Delivery-Indefinite-Quantity (IDIQ) requirement is to provide a contracting mechanism in support of various Bureaus and Offices within the Health Resources and Services Administration (HRSA). The contractor shall be required to provide TA in a range of areas. This includes providing TA for Federally Qualified Health Centers, National Cooperative Agreements, State/Regional Primary Care Associations, Health Center Controlled Networks, Federally Qualified Health Centers Look-Alikes, state agencies addressing the health and public health needs of women and children (including children with special health care needs),universities, rural community-based programs, rural public health departments, Critical Access Hospitals/Small Rural Hospital, health care providers, health care clinicians, AIDS service organizations, federal staff, and grant recipients.

The TA provided under this contract will be in response to the specific needs of HRSA programs. This may include the development of written materials, assisting with organizational needs, administrative needs, training of HRSA staff and programs on various topics, improving internal systems, assessing and assisting in targeted program areas, developing and improving internal management systems, peer-to-peer training, coordination and facilitation of webinars, outreach efforts, and sustainability. TA services may also include the development of training and education materials to improve access to health care for medically underserved and vulnerable populations. TA services may also include phone consultation, site visits, virtual consultation, note-taking/transcription services, report writing, quality assurance consultation, analysis and dissemination of evidence-based practices for health care delivery, as well as quality improvement recommendations. The services procured under this contract may be provided in a variety of forms depending on the specific requirements in the Task Order request.

The contractor shall have staff and expert consultants qualified and experienced in a range of specialty areas as described within this statement of work and supporting attachments. The contractor shall have and maintain a roster of consultants that are geographically, racially/ethnically, and linguistically diverse as well as represent the range of expertise needed to accomplish the tasks in the statement of work.

The contractor shall provide all personnel, materials, facilities, services, and equipment necessary for the performance of work as stated in individual Task Orders issued under this contract. The following describes the typical tasks that may be required of the contractor in the performance of Task Orders awarded. Task Orders shall not necessarily reflect/include the entire set of task areas listed below. HRSA will specify the actual tasks along with the project-specific information required for completion of the Task Orders. Each Request for Task Order Proposal (RFTOP) will clearly specify the requirement areas for that given Task Order.

III Tasks

1. HRSA TA Tracking System (TATS)

The HRSA TA Tracking System (TATS) is the automated, government-owned, web-based system used to support program staff and stakeholders record and track the details of the TA services provided to HRSA award recipients. TATS is configured to accurately track the TA delivery services provided to stakeholders of a diverse inventory of programs, by multiple contractors, concurrently. TATS includes handbooks for bureau staff and TA contractors and supports the entire TA lifecycle once a Task Order has been awarded. The TA lifecycle includes all aspects of the TA process – from program initiating a TA request through filing the TA report and evaluating the TA services that were provided under a Task Order.

The contractor staff will be granted access to TATS by registering the users via the existing User Access Control (UAC) module in the Electronic Handbooks (EHBs). There are two roles identified in TATS for contractor staff: TA Coordinators (TAC) and TA Reviewers (TAR). TATS will also be used to record the TA services each contractor provides the Bureau/Office they are supporting under the awarded Task Order. The contractor shall provide a roster in a defined Excel template provided by the Task Order Contracting Officer Representative (COR) after Task Order award. The roster will be imported into TATS after a Task Order is awarded. Only the contractor shall have access to their staff in TATS. Each contractor shall have the ability to manage and update their staff expertise and profile in TATS.

The contractors will be granted access to the enterprise HRSA TATS System and therefore will need to obtain credentials for those individual using the system.

Contractors will need to pass the online HRSA security course, complete forms HHS-745 and OF-306, provide two forms of identification, and provide fingerprints prior to being assigned a HRSA email account which is needed to access TATS. The contract and/or task order COR will provide the required forms, training links, and will assist with the credentialing process after task order award.

Once a Task Order is awarded, individual task requests are routed to the contractor in TATS and the contractor will then select and assign the required staff (from their rosters) that will provide services under the awarded Task Order. HRSA will provide contractor staff with online training on the required use of TATS and will explain the contractor roles and responsibilities for using the system. Training on the TATS and details of its use will be provided to contractor staff after the award of a Task Order is made.

2. HRSA Program Support

The contractor shall provide oversight and assurance that the following HRSA program support tasks are completed at the standards indicated at the Task Order level:

a. Meetings

1. Kickoff Meeting

The contractor shall participate in an initial meeting with the HRSA Contracting Officer (CO), Task Order COR and designated HRSA officials within 14 business days from the effective date of eachTask Order awarded under this contract, to obtain relevant background information, review the statement of work, discuss the items to be delivered and delivery schedule, goals and objectives, processes, periods, and priorities. The contractor shall review background materials provided by the COR prior to the initial meeting. The Task Order COR will provide the contractor with the background information via email within 10 business days from effective date of each task Order. The kickoff meeting location guidelines and required communication platform will be determined at the Task Order level.

2. Other Meetings

The contractor shall participate in meetings with the COR and other stakeholders, as requested and at the frequency determined at the Task Order level. These meetings will be to discuss project updates and any critical issues. The contractor shall notify the COR within one (1) business day, if issues arise that prevent the contractor from attending a meeting. The contractor shall also notify the COR within three (3) business days of any event which will create a delay in the schedule and/or result in additional cost to HRSA. All notifications shall be submitted electronically to the COR in writing and shall document the reason for the delay, the status of the budget, the impact on the project, and the action the contractor is taking to bring the project back on schedule.

b. Webinars

Within four (4) weeks from effective date of each Task Order, the contractor shall propose a series of webinar topics which will augment and/or highlight already developed materials in the field. The contractor shall determine those topics in consultation with HRSA staff, engagement with grantees, and findings from current research.

The contractor shall propose a list of ten (10) webinar topics and in consultation with the HRSA project lead, finalize the selection of two (2) topic areas. Previous Webinar Topics have included:

• Workforce: Recruitment and Retention of Behavioral Health Providers;

• Training Behavioral Health Providers on Behavioral Health Integration

Workflow;

• Impact of Behavioral Health on Retention in Care;

• Impact of Trauma in Integrated Care Settings and the Impact on Persons with

Lived Experience;

• Approaches to Integrated Care for HIV+ Individuals over 50; and

• Sustaining Behavioral Health Integration Models in Safety Net Provider Settings.

The contractor shall provide the HRSA project lead with a project plan for each 90 minute webinar within six (6) weeks of approval of the two (2) webinar topics. The project plan shall include up to three (3) proposed speakers per webinar; key themes and study questions for the topic; identified contractor staff and subject matter experts (consultants) who will work on the webinar; timeframe for completion of a PowerPoint presentation and related materials, including draft and final for review by the COR and final version for communication clearance; description of how the webinar will be evaluated; and explanation of quality control monitoring process; as well as a communications plan for each webinar.

The contractor shall work with the COR in planning the webinar, including identifying potential speakers, at least two (2) months before its proposed date. The contractor shall make all necessary arrangements for the webinar, including inviting the speakers and coordinating the presentations. The webinar announcement should be submitted to the COR for review at a minimum of six (6) weeks before the date of the webinar. The contractor shall promote the webinar three (3) weeks before its date.

The contractor shall send the information that will be used in the webinar (e.g. slides, discussion questions, etc.) to the COR for review no later than two (2) weeks prior to the webinar date. This will allow the COR to seek additional feedback and review from federal subject matter experts on the webinar content.

A system for webinar registration shall be used; the webinar registration and broadcast platform should have the capacity for approximately 2,000 unique portals.

The webinar platform used should include an archived audio-version of the webinar for posting on the project website and for follow-up viewing for the length of the contract period.

E-mail registration lists and number of participants for each webinar shall be collected by the contractor, and feedback by webinar participants should be sought by the contractor following each presentation with a summary report shared with the HRSA lead and COR.

c. Curated Resource E-mails

The contractor shall establish an e-mail database with the initial set of e-mail addresses provided by the HRSA project lead within four (4) weeks from effective date of each Task Order. The contractor shall post a curated e-mail on a current topic in integrated care (e.g., SBIRT, workforce development, financing and sustainability, data/evaluation, health information technology, health disparities and cultural competency, evidence-based and best practices in primary and behavioral health integration). The contractor shall propose ten (10) curated e-mail topics within four

(4) weeks from effective date of each Task Order to the HRSA task lead and COR.

The contractor, in consultation with the HRSA task lead and COR, shall finalize the selection of six (6) e-mail topics within six (6) weeks from effective date of each Task Order. The contractor shall note, however, that the topics may change given the priorities of HRSA leadership and needs to be flexible to change topics throughout the contract year.

The contractor shall work with the HRSA task lead and COR in identifying and approving subject matter experts or consultants for the development of the curated e-mail content at least two (2) months prior to the posting date. The contractor shall send the e-mail content to the HRSA task lead and COR for review at least three (3) weeks before the curated resource e-mail is posted, allowing for review time by other federal experts and revisions by the contractor.

The contractor will work with SMEs and key contacts to post informative content and share resources (including tools and other TA documents), as appropriate. Interest generated by curated e-mails can lead to additional requests for telephonic TA.

Curated e-mails will, whenever possible, reflect roundtable discussions to expand the reach to the HRSA audience.

d. Reporting

The contractor shall submit all required and ad hoc reports are submitted to the Task Order COR in accordance with the deliverable schedule and as specified in individual Task Orders. Generally, each Task Order will request monthly reports that provide the following:

1. Status of the Work

In a narrative and table, highlight the status of activities by task, including any significant events, trends, or problems that occurred along with suggestions for resolution and recommendations for improving performance. The report should include an explanation of any deviation(s) from the approved work plan, if applicable.

2. Financial Status of the Contract/Task Order

(Note: contractors are not required to provide this detail for Firm Fixed Price (FFP) Task Orders).

The contractor shall document the number of person hours and budget amounts used for each task during the month, the amounts on a cumulative basis and the remaining balance on the contract/Task Order. The format should be such that invoices can clearly be associated with the tasks and costs described in the monthly progress report.

3. TA Site Visit Reports

The contractor shall use the proper time frame and format is used for reporting site visit activities as indicated at the Task Order level. Generally, site visit reporting is executed using TATS and must include award recipient-focused performance improvement recommendations based on the findings and discussions resulting from the site visit. All documents/artifacts pertaining to any site visit shall be uploaded into TATS. The contractor-assigned Point of Contact (POC) for each site visit shall communicate and consult with designated HRSA POC any questions, concerns or areas of non-compliance as directed in the Task Order guidance. Additional TA Site Visit reporting requirements will be communicated at the Task Order level.

4. Final Report

The contractor shall ensure the submission of a final report at the end of each Task Order. The reporting format, required content and schedule will be determined at the Task Order level. Traditionally, the elements of the final report may include the following. Details of the requirements for each element will be provided at the Task Order level:

• Executive Summary – The executive summary includes the major information that the report contains and should summarize the following:

• Introduction and Background – Describe the purpose of the report and target audience. Outline the goals, objectives and success criteria.

• Contract and Task Order Activities and Milestones – Describe the major activities and milestones achieved during the Task Order. Identify the performance of the project milestones and corresponding deliverables, i.e., were all deliverables achieved with high quality and on time? If not, provide explanation of why high quality and timeliness were not achieved.

• Performance Measurement – Provide a comparison of actual project performance to project objectives. Describe the level of success in meeting the goals and objectives of the Task Order. If some objectives were not met, describe the reasons why.

• Conclusions and Recommendations – Briefly summarize any conclusions that can be drawn from the work and discuss any opportunities for improvement that have been identified. Provide detailed support for any considerations or recommendations and actions identified.

• Funding Summary –Summarize cumulative contracts funds obligated, invoiced and paid, and identify any contract funds remaining per year of the contract.

• Appendices – Include any appendixes to provide clarity; and

• Additional information specified in the Task Order.

5. Ad Hoc Reports and Ad Hoc Requests

For ad hoc reports, expertise may be needed in the following areas (as well as others): literature reviews; in-depth secondary data analysis with an accompanying brief paper, drafting issue briefs (five to seven (5-7) pages) on an emerging issue in integrated care of importance to the HRSA grantee community.

At times, these requests will come with short notice.

The contractor shall also respond to ad hoc requests from the HRSA project lead.

The contractor shall provide subject matter expertise regarding integrated care and HRSA-funded safety net providers and training/education programs, as well as rural-focused subject matter expertise around program sustainability, healthcare network development and capacity building and rural health care policies and its implications for small rural health care providers.

Topics might include, but are not limited to:

• Providing HRSA staff HRSA rural grantees, and HRSA telehealth grantees technical advice on grant program deliverables, including evaluation plans, strategic plans, marketing plans, business plans, sustainability plans, organizational assessments and the Performance Improvement Management System (PIMS) in order to maximize the quality of the data collection and reporting procedures.

• The contractor shall provide guidance and resources related to the topical areas of the grantees, grantee deliverables, as well as evidence-based models, sustainable practices, data reporting, improvement of prevention and treatment efforts, program marketing, network/board development, capacity building, chronic disease management, and service delivery and how service delivery can support direct services.

• Telehealth reimbursement, and telehealth technologies.

• Convening state-level grantees (for example: MCH Title V and SAMHSA

Block Grant programs) to address an emerging behavioral health/primary care integration issue of mutual importance or emerging rural health care policy changes.

• Updates to specific webpages on the Center’s site as well as development of new topic-specific webpages.

• Adding best practice examples to the Center website in a self-contained section (similar to the Rural Health Information Hub: see: Rural Health Models and Innovations https://www.ruralhealthinfo.org/community-health/project-examples).

• Expanding use of tele-consultation and care coordination models to support medical clinicians to screen and treat pregnant and postpartum women for behavioral health conditions through: (1) trainings and toolkits on depression screening, assessment and treatment; (2) telephonic access to perinatal psychiatric consultation for providers serving pregnant and postpartum women; and (3) care coordination to link women to individual psychotherapy and support groups.

• Support for helping HRSA grantees develop or adapt existing evidence-based protocols, guidelines, treatment algorithms, and trainings (in-person and/or webinars) for clinicians and their staff on culturally competent, behavioral health screening, assessment, referral, and treatment for pregnant and postpartum women. Assisting grantees as they develop trainings, via webinars (distance learning), for clinicians and their staff on how to use these protocols in practice.

https://www.ruralhealthinfo.org/community-health/project-examples https://www.ruralhealthinfo.org/community-health/project-examples

• During the last quarter of the contract year, conduct a focus group to identify integrated care priorities by tapping into a subset of HRSA-funded programs, including: health centers, primary care associations, maternal and child health programs, HIV provider organizations, academic training programs, rural health providers, and HRSA project officers. This may include organizing listening sessions at grantee annual meetings to identify current needs concerning integrated care and use that information for the next contract year.

3. TA Types and Methods

a. Site Visit Delivery Method

The contractor shall provide a site visit delivery method that accommodates the delivery of TA activities through varied modalities, which may include: on-site, via telephone, email, or using a visual web-based platform (e.g. Skype, Adobe Connect).

This will be determined at the Task Order level. The details of the TA delivery requirements will be provided at the Task Order level, which include site visit coordination, along with site visit and TA feedback. The general purposes for this method of TA delivery focus on:

• New Awardees o Organizations that do not currently receive funding from the respective Office or Bureau

• Program Compliance Verification.

o Whenever areas of non-compliance with program requirements are identified and subsequently, a condition(s) of award is issued, this type of site visit may be conducted to either verify whether the compliance issue has been fully resolved and/or to verify what progress has been made towards reaching compliance based on the corrective actions communicated through the condition(s).

• Evaluation and Assistance with Priority Performance.

• Verification of Critical Need.

• Quality Outcomes Assurance.

b. Strategic Management TA

The contractor shall provide TA services to awardees and federal staff in the following areas, and as indicated at the Task Order level:

• Work process improvements.

• Management consulting and coaching and mentoring.

• Strategic planning and organizational development.

• Meeting facilitation.

• Coalition and consensus building.

• Negotiation techniques with constituents and external partners at the national, state, local, and private-sector levels.

• Leadership development and training.

• White papers, short evaluation assessments.

• Evidence-based practice monitoring.

• Development of peer-to-peer learning resources for managers, staff, and awardees to improve programmatic performance and stakeholders satisfaction.

• Assistance to grantees with providers who would like to use telehealth technology to improve access to healthcare, consultation among providers, distance learning, or who need to better understand regulatory or reimbursement issues in telehealth;

and

• Information Technology Systems development support.

c. Program Assessments TA

The contractor shall perform program specific data analysis services that will support awardees with improving their effectiveness and ultimately public health outcomes in the immediate and long-term future. The contractor shall use the resources identified at the Task Order level, which may include:

• The engagement of program stakeholders.

• The development of a data collection and data validation plan.

• The development and implementation of evaluation plans.

• The development and implementation of sustainability plans.

• Briefing of outcomes to HRSA and its stakeholders.

• Providing assistance to awardees in quantifying real outcomes, quality and general performance.

• The establishment of a monitoring plan; and

• The development of an evaluation design plan.

In addition, the contractor shall provide awardees with best practices, lessons learned, common challenges faced, and outcomes from the federal investment.

d. Financial Management TA

This task area focuses on business planning, cost containment strategies, financial audit support, Federal Tort Claims Act (FTCA) risk management assessments and reviews, financial recovery plan review, and financial consultation. This task area may involve assisting grant recipients and awardees with financial planning, budgeting, cash management, accounting systems, systems for payroll, accounts payable, accounts receivable, third-party reimbursements, grants management, cost allocation, fiscal reporting, non-federal share, sub-recipient monitoring, and audits.

These assignments typically require one consultant for 5 days on-site or via teleconference, 2-4 days of preparation and two days of post training work.

The contractor shall provide assistance with managing grant resources, including assistance with business planning, strategic planning, healthcare network infrastructure development, implementing the use of telehealth technology, and conduct strategy and resource management, review business processes and policies, specific issues to the grantee, examination and presentation of best practices. In addition, the contractor shall apply federal poverty level guidelines to assess imposition of charges and financial sustainability of grant recipients, awardees.

Additional TA services to be provided include:

• Financial recovery plan development for financially troubled organizations.

• The identification and examination of awardee-based business practices to control cost and the associated risks of implementation.

• Financial data analysis, including cost comparisons across services, providers, and geographic areas.

• Financial savings analysis for the use telehealth visits compared to in-person visits.

• The review and assessments of financial statements.

• Corrective action plans.

• Federal Acquisition Regulations (FAR), Code of Federal Regulations (CFR), and other federal regulations; and

• General grants management tasks, such as fiscal reporting, audits to implement financial planning and reporting requirements.

The details of the elements listed above and any other Financial TA services will be provided at the Task Order level.

The contractor shall perform OMB Circular A-133 single audits and financial recovery plan reviews. These activities include the review, analyzing, and summarizing of grant recipient audit submission files, grant recipient change requests, Circular A-133 compliance supplements, and audit management letters as well as preparing one-pagers summarizing the audited financial statement information.

e. Supporting Implementation of Evidence-based Practice

This task area focuses on coordination of grant recipient activities, training and education on specific health topics, and analysis and dissemination of evidence-based, innovative practices, policies, and tools. This task area may involve assisting grant recipients in peer-to-peer information sharing, convening stakeholders of various specific health topic areas, conducting needs assessments, and developing and providing training and education modules for health care practitioners, consumers, family members, and the general public.

The contractor shall coordinate state and local public health agency grant activities on a national level, including assistance with partnership building, data collection, information sharing, and specific issues to the grant recipients.

Additional TA services to be provided include:

• Development of reports, briefs, toolkits, webinars, etc. on various specific health topics affecting vulnerable populations.

• Planning, hosting, and facilitating in-person meetings with grant recipients, topic experts, and various stakeholders; and

• Development of public-facing, free-standing websites that act as a repository of resources, publications, and evidence-based practices.

The details of the elements listed above will be provided at the Task Order level.

f. Population Health Outcomes and Quality TA

This task area involves TA with clinical and general health outcomes performance improvement. The measurement of awardees’ clinical processes and procedures is essential to ensuring that the best modifications are implemented to increase the quality care and clinical outcomes. In addition to existing clinical elements, regular performance assessments against HRSA’s population health priorities are used to inform the Agency on its current performance and strategic planning.

In addition, this task area requires a method of TA that will provide guidance and best practices to achieve operational goals and objectives, the implementation of Quality Improvement/Quality Assurance (QI/QA) plans and the development of tools that support long-term success.

The implantation of a robust QI/QA programs by HRSA’s awardees is essential to the long-term success of HRSA’s programs. As such, the contractor shall support the development of priorities and set QA/QI goals using continuous improvement methodologies (e.g. Plan, Do, Study, Act-PDSA Cycles), continuing improvement of care and support services, and providing feedback to address problems and concerns.

The specific details and expectations of this type of TA will be provided at the Task Order level.

Further, the contractor shall provide TA that supports awardees and their ability to successfully navigate through the ever-changing population health landscape through the development and delivery of TA to improvements in clinical outcomes, both of a general and HRSA-priority nature. The contractor shall collaborate with awardees to develop specific clinical and health prevention indicators to be measured for the Contact Option Year.

g. Community Outreach TA

This task area may involve outreach by use of social media and the contractor shall research different methods of communication to fit different purposes and different audiences. This may include determining how to employ a set of “new media” technologies (e.g., Facebook, Twitter) in various aspects of public health practice, various care settings and the benefits and limitations of various “new media” technologies. The contractor shall not create or establish additional HRSA social media accounts.

h. Community of Practice

The intent of a Community of Practice (COP) is to engage participants in active learning within their team and in dialogue with other participating organizational teams. Through organizational self-assessments, didactic learning on specific integrated care topics, goals setting and work plan development, each team will move ahead on aspects of integration that can strategically benefit their organization.

COPs afford participants the opportunity to work in a group to solve a recognized challenge when integrating primary and behavioral health care and support dialogue among participants and the consultant/subject matter expert. The goal of each COP is to develop a solution for the recognized challenge that can be shared with a national audience.

The contractor shall develop a series of Community of Practice topics, in partnership with the HRSA project lead that will augment and expand knowledge in the chosen COP field. Each Community of Practice will include: a kickoff, monthly meetings among COP participants, and a closing meeting. The contractor shall propose to the HRSA project lead the timing that works best for the participants. Community of practice may be managed in a variety of ways including on-site and distance-based modalities (audio, internet). The contractor shall summarize COP participant experiences and the likelihood that information gained will be incorporated into participants work along with assessments on the effectiveness of the COP itself. COP length and size will be determined at the task order level.

COP may consist of providing a HRSA lead with a project plan for each Community of Practice within nine (9) weeks of approval of the COP topic, including: a team of at least three (3) subject matter/technical experts to work with the Community of

Practice and assigned contractor staff; expected mission and objectives of the COP;

proposed invitees; timeframe for launch, management, and completion of the COP (including development of learning materials for the COP participants); associated dissemination plan including a written deliverable on the Communities of Practice’ findings/experience (including time for draft and final review by the HRSA project lead); description of how the project will be evaluated and measured; include participant goals for their participation in the COP as well as proposed measures of organizational impact from participation; an explanation of a quality control monitoring process (including feedback by COP participants sought by the contractor following each COP event); and a communications plan for each COP.

When recruitment falls short, the contractor shall engage in an effort to increase interest in the Community of Practice through additional recruitment efforts. When the level of interest exceed available slots, the contractor shall establish a waiting list.

Within four (4) weeks following conclusion of each Community of Practice, the contractor shall submit to the HRSA project lead, a summary of the activities, successes, and challenges encountered during the course of Community of Practice.

i. Rural Community of Practice

Through Section 711 of the Social Security Act and Section 330A of the Public Health Service Act, HRSA 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 through the use of a network or consortium model. Per these legislative authorities all services must be provided in rural areas as designated by HRSA. Programs under these authorities range from singular pilot programs focused on specific issues in rural areas or Administration and Department priorities (including but not limited to opioids and substance abuse, value-based care, maternity and obstetrics care, and mental health) to regular appropriated programs funded annually. More specifically, the grantees from these programs are non-categorical and cover a range of topical areas including areas such as chronic disease, oral health, behavioral health, school-based health programs, and cancer screening.

Some activities supported through these programs include outreach and wellness activities, conducting a needs assessment, integrating administrative, financial and clinical systems of care within rural health care networks, developing quality improvement strategies etc. A key element of these programs is to be able to sustain their program or facets of their program after the Federal funding ends.

The intent of a Rural COP is to develop and conduct TA to provide Federal Office of Rural Health Policy (FORHP) grantees with the expertise and skills needed to successfully implement their programs and create sustainable outcomes with consideration to the changing and complex rural health landscape.

Moreover, with over 200 active direct service grants, the rural COP will support rural health care organizations as they navigate the challenges of health service delivery within their communities. These include, limited access to health care services, health care workforce shortages, and increased rates of morbidity and mortality, and payment systems that typically do not acknowledge the unique situation of small volume. As a result, the TA delivered should provide grantees with strategies, tools and resources to support alleviating some of these challenges. Potential TA topics include, leadership development, consensus building, developing a business plan, partnership commitment and engagement and utilizing evidence-based practices/promising practice models.

Specific to this Rural COP, the TA provided will be in response to the specific needs of rural programs and communities and may include but not limited to, individualized TA, peer learning, telephonic, generalized TA, round table discussions, and expert consulting. More specifically, individualized TA is capacity-building support provided to the grantee through regular communication and is based on assessment of grantee challenges, goals, and identified focus areas related to positioning the program and consortium for long term sustainability post-federal funding. Given that each grant program has a separate cohort changing every one to three years, this relationship-based support is highly individualized and flexible to the emerging needs, challenges, and opportunities grantees and their partners face through their project period. Peer Learning among grantees is highly valued by grantee program directors and program staff and is a central component to TA delivery which includes: Peer Group Calls and Peer Group Message Boards; Peer-to-Peer Site Visits;

and Reverse Site Visits. Moreover, generalized TA encompasses the areas of capacity building that are relevant to most or all of the rural community-based grantees.

Generalized TA is designed to achieve efficiencies where grantee support and training needs are similar and content can be effectively delivered to large groups via webinars, workshops, etc.

The TA provided should be able to utilize available HHS and HRSA data resources in order to ensure the data collected by grantees is accurate and representative of their projects. Each grantee would be assigned a TA team lead with experience in the focus areas of the grantee; this assigned rural TA specialist will work with that grantee over the course of its project period. Lastly, expert consulting should be employed when grantees require TA that is highly technical or specialized. The contractor shall engage subject matter experts for one-on-one consultation and presentations to peer groups and grantee cohorts. To achieve the greatest impact, all components of the TA approach are integrated, building on and reinforcing one another, with the goal of meeting the technical and adaptive needs of each grantee.

j. Telehealth Community of Practice

Through Section 330A of the Public Health Service Act, HRSA funds grant programs supporting expanding access to, coordinating, restraining the cost of, and improving the quality of essential health care services. These programs range from the Health Center program, the maternal and child health programs, HIV/AIDs prevention and treatment programs, the rural health programs, and telehealth programs. Over 1,000 of HRSA awards using telehealth to improve access to health care in fiscal year 2018.

The intent of a Telehealth Community of Practice is to develop and conduct TA to provide HRSA grantees using telehealth (or those that would like to use telehealth) with the expertise and skills needed to successfully implement their programs, improve access to health care, demonstrate the financial value of using telehealth technology, build an evidence base with the outcomes of a telehealth visit vs. an in-person visit, and create sustainable programs amidst the changing and complex telehealth technology and reimbursement environment.

Specific to this Rural COP, the TA provided will be in response to the specific needs of telehealth programs and may include but not limited to, individualized TA, peer learning, telephonic, generalized TA, round table discussions, and expert consulting.

Given that each grant program has a separate cohort changing every three to four years, this relationship-based support is highly individualized and flexible to the emerging needs, challenges, and opportunities grantees and their partners face through their project period. Peer Learning among grantees is highly valued by grantee program directors and program staff and is a central component to TA delivery which includes: Peer Group Calls and Peer Group Message Boards; Peer-to- Peer Site Visits; and Reverse Site Visits. Moreover, generalized TA encompasses the areas of capacity building that are relevant to most or all of the telehealth grantees.

Generalized TA is designed to achieve efficiencies where grantee support and training needs are similar and content can be effectively delivered to large groups via webinars, workshops, etc.

The TA provided should be able to utilize available HHS and HRSA data resources in order to ensure the data collected by grantees is accurate and representative of their projects. Lastly, expert consulting should be employed when grantees require TA that is highly technical or specialized. The contractor shall engage subject matter experts for one-on-one consultation and presentations to peer groups and grantee cohorts. To achieve the greatest impact, all components of the TA approach are integrated, building on and reinforcing one another, with the goal of meeting the technical and adaptive needs of each grantee.

k. Information Technology and Communication TA

The contractor shall provide TA on the uses of information technology tools and health-delivery methods, such as, electronic health records, telehealth and telemedicine, telecommunications technologies, and other methods as determined at the Task Order level.

In addition, the contractor shall employ communication methods technical methods that support working with stakeholders located in rural or frontier areas. Technologies in this task area may include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communication.

The contractor shall provide assistance with two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site complement or improve the grantee recipient’s ability to provide care may be needed.

l. Telephonic TA

The contractor shall provide Telephonic TA (TTA) to the HRSA grantee community on all aspects of behavioral health/primary care integration. All TTA will be evidence-informed, data-driven and timely in its relevance to the field. Per the 21st Century Cures Act, TTA can be made available to States, political subdivisions of States, Indian tribes or tribal organizations, outpatient mental health and addiction treatment centers, community mental health centers that meet the criteria under section 1913(c), certified community behavioral health clinics under section 223, primary care organizations such as federal qualified health centers or rural health clinics as defined in section 1861(aa), or other entities engaging in integrated care activities.

The contractor will effectively and independently market TTA opportunities. The contractor will actively engage HRSA stakeholders to encourage uptake of TTA.

Note to contractor: While the number and nature of TTA events may vary, there may be 130 initial phone request and 65 follow-up phone requests for the base year of the Task Order and 130 initial phone requests and 65 follow-up phone requests for each Option Year of the Task Order. The contractor should have a minimum of 30 consultants from which to choose at any given time. Specific details shall be determined at the task order level.

TTA may consist of a combination of:

• Real-time telephone TTA, including referral to existing TA materials and referral to possible outside sources for TA. Connecting consultees to peers for peer to peer learning.

• Follow-up research on the TTA topic and response directly to the requestor, either via phone or e-mail.

• TTA responses should be provided within 24 hours of the initial request.

m. Group TA Virtual Roundtable Discussions

Group TA Virtual Roundtables are intended for a pre-identified group of grantees and is structured to allow for extended dialogue with the participants and subject matter experts. The focus is often on a specific integrated care topic of interest to a pre-identified grantee group.

For each proposed Roundtable, the contractor shall provide topic options, a work plan, a plan for registration, and a description of proposed follow-up (such as an e-mail to participants highlighting key themes discussed as well as a list of available Center TA resources and other nationally recognize TA material).

In order to ensure the topics are timely and of immediate value to the HRSA grantee community, prior to each Roundtable, participants will be queried on their practices related to the upcoming Roundtable topic areas. These responses will be used to inform the Roundtables and support discussion. Sessions will run between 60-90 minutes. Roundtable discussions will utilize a blended audio-visual format that allows for direct information sharing such as PowerPoint slides, and sharing of documents and resources in real time. Any presentation material should be shared with the HRSA Task Lead at least ten (10) business days prior to the Roundtable. This format also provides direct access for attendees to participate and ask questions while SMEs present. Following each Roundtable, a satisfaction survey will be sent to participants.

Participants will receive a follow-up e-mail with a summary of key themes discussed and a list of relevant CIHS and other resources that reflect the topic of conversation.

The contractor shall produce post-roundtable reports, including a description of the topic, number of participants, recording link, and questions asked. Roundtable reports are shared with the COR and GPOs within two (2) weeks of the roundtable.

Past Roundtable Discussions Have Included:

• Integration of Behavioral Health with HIV for AIDS Education and Training

Centers.

• Addressing Opioids in integrated care settings.

• Chronic Pain Management-Implementing Pain Management Protocols.

• Enhancing Tele-SUD Treatment in Rural and Frontier Communities.

• Supervisory skills in Integrated Care Settings.

• Behavioral Health and Oral Health.

• Sustainable Fiscal Practices; and

• Population Health Management.

n. Group TA Reverse Site Visits

Group TA Reverse Site Visits is intended for a program cohort of grantees and is structured to allow for in-person extended dialogue with the participants and subject matter experts. The focus is often on implementation of evidence-based models, analysis of evaluation or other types of data for program improvement or strategies for improved network partner collaboration.

For each proposed Reverse Site Visit, the contractor shall provide topic options, an agenda, a plan for registration, and a description of proposed follow-up (such as an e-mail to participants highlighting key themes discussed as well as a list of available resources and other nationally recognize TA material).

o. One-On-One Coaching TA

The intended grantee audience will be identified through a prioritization process based on: 1) what program data indicates regarding grantees who could benefit from the Coaching Model; or 2) specific instructions from a bureau lead on which grantees to target; or 3) a general invitation request to a set of grantees.

As part of outreach/marketing for the Coaching Model, the contractor shall hold a web-based presentation to encourage the uptake of coaching and introduce the opportunity. The goal is to help organizations build their initial approach to integration or overcome impediments to successful integration (for example: billing challenges, workforce recruitment and retention issues, how to implement an effective assessment of integrated care needs and development of benchmarks). The contractor shall use experts in the field to provide one-on-one coaching TA.

Coaching Model to be Used with Each One-On-One Engagement:

• Referral from Telephone TTA or inquiry from direct marketing by the Center;

• Sharing with the interested organizations integration assessment instruments such as:

• AHRQ Academy Playbook (https://www.integrationacademy.ahrq.gov/playbook/about-playbook).

• Center assessment instruments (https://www.integration.samhsa.gov/operations-administration/assessment-tools).

• University of Washington Assessment Tools (http://journals.sagepub.com/doi/pdf/10.1177/1062860615618783 and https://www.integrationacademy.ahrq.gov/playbook/about-playbook https://www.integration.samhsa.gov/operations-administration/assessment-tools https://www.integration.samhsa.gov/operations-administration/assessment-tools http://journals.sagepub.com/doi/pdf/10.1177/1062860615618783 http://www.safetynetmedicalhome.org/sites/default/files/Implementation- Guide-Behavioral-Health-Integration.pd).

• Initial orientation e-mail, including assessment instruments.

• Initial coaching call #1 will include a review of assessment findings, discussion of specific goals, description of coaching process. Each call will last no less than one hour and no more than ninety minutes.

• Coaching call #2 will include checking on initial progress; next steps towards…