Live Task Order1.docx

TASK ORDER #1: National Level HIV Resource Allocation Model

STATEMENT OF WORK

I. Background:

The Centers for Disease Control and Prevention’s (CDC) latest estimates show that approximately 50,000 Americans become infected with HIV annually. As a result, the number of people living with HIV in the United States, now at nearly 1.2 million, continues to grow by tens of thousands each year, creating more opportunities for HIV transmission. According to the test and treat cascade, nearly 1 in 5 people (about 240,000) don't know they are infected and are at increased risk of HIV transmission [1]. Therefore, testing is a critical component of HIV prevention. Of all people with HIV who know they are infected, about half are getting medical care and only a third are on antiretroviral treatment (ART) and have the HIV virus under control [1]. Results of a randomized control trial among serodiscordant couples indicated that ART significantly reduces the incidence of HIV transmission to the negative partner [2]. Therefore, in addition to the treatment benefits conferred to HIV positive persons, programs aiming to retain or re-engage them in clinical care can play an important role in HIV prevention.

In July 2010, the White House released the National HIV/AIDS Strategy (NHAS), a comprehensive roadmap for reducing the impact of HIV. The NHAS sets clear goals for HIV care and prevention in the United States over the next 5 years that include: reducing incidence by 25%, increasing the proportion of people living with HIV who know of their infection to 90%, and increasing the proportion of patients linked to clinical care to 85%.

To guide CDC’s HIV prevention planning efforts and funding priorities towards the goals set in the National HIV/AIDS Strategy (NHAS), DHAP seeks the support of formal decision models to allocate prevention dollars in a manner which maximizes the impact of efforts for those at risk for and living with HIV infection.

[1] Vital signs: HIV Prevention Through Care and Treatment — United States. Morbidity and mortality weekly report, 2011. 60(47): p. 1618-1623.

[2] Cohen, M.S., et al., Prevention of HIV-1 Infection with Early Antiretroviral Therapy. New England Journal of Medicine, 2011. 365(6): p. 493-505.

II. Purpose:

The purpose of this task order is to develop a national-level HIV resource allocation model intended for use by the CDC. This model will include a detailed epidemic projection component parameterized with the latest US data. The model will allow for investment in a wide variety of HIV related interventions related to narrowing the gap in the HIV test and treat cascade.

III. Scope of Work:

Independently, and not as an agent of the government, the Contractor shall furnish all the necessary personnel, facilities, supplies, and equipment required to develop the HIV resource allocation model. All models developed, all source code to the model, and all supporting materials such as user’s guides and technical instruction manuals will become the property of the Government. The requirements of this task order fall under the following Task Areas of the basic contract: Resource Allocation Management, Technical Assistance and Study Analysis.

IV. Technical Requirements:

For each task, the contractor shall have ongoing meetings with the Technical Monitor(TM) and designated site staff. Meetings may include face to face, web conference calls, web-based presentations, or teleconferences. The Contractor should expect to conduct one (1), one-day, face to face, kick-off meeting at CDC offices in Atlanta, and one status meeting to discuss the progress of the deliverables.

The Contractor shall perform the following tasks:

Task 1. Participate in a kick-off meeting with the Technical Monitor (TM) and DHAP staff to discuss the tasks outlined in the statement of work. The Contractor shall plan for a one day meeting to be held in Atlanta, GA. The contractor shall submit a synopsis of the kick-off meeting to the TM within 3 days of the meeting.

Task 2 Design a national-level HIV resource allocation model intended for use by the CDC.

The epidemic model structure, embedded within the resource allocation model, shall consider: gender, transmission risk group, circumcision, diagnosis status (negative, positive and aware, positive and unaware), CD4 count and viral load brackets, and care and treatment status. Transitions within the model shall consider investment in interventions and outcomes of the interventions (transmission rate functions, Quality Adjusted Life Years QALYs,) Interventions shall include testing, notification of a new HIV diagnosis, condom usage, serosorting, circumcision, changes in numbers of casual and main partners and in number of acts per partnership, Pre-Exposure Prophylaxis (PrEP), as well as linkage to and retention and re-engagement in care and timing of initiation of and adherence to ART. Should the design of the model call for a third party engine to resolve the resource allocation problem, then it must be compatible, in terms of its performance and integration capacity, with the solver platform of Frontline Systems.

*Frontline Systems, Solver Platform, 2012: Incline Village, NV. www.solver.com.

Task 3: Design Document for Resource Allocation Model Subtask 3.1. Write a design document for the national-level HIV resource allocation model, including all assumptions, and strengths and limitations of the design.

Subtask 3.2. Present the TM and DHAP staff the resource allocation model design and obtain feedback.

Subtask 3.3. Incorporate feedback into the design document and submit a revised draft design, to be submitted to the TM for approval by DHAP.

Subtask 3.4. Develop the Resource Allocation Model based on the approved design document.

Task 4. Parameterization and Data Input of Resource Allocation Model.

Subtask 4.1. Collect all data inputs required to fully parameterize the Resource Allocation Model.

Subtask 4.2. Write a data definition document outlining all data inputs, values, ranges, sources and references and justifications for all assumptions made.

Subtask 4.3. Present all the data inputs and obtain feedback from the TM and DHAP staff.

Subtask 4.4. Incorporate feedback and submit a revised a data definition document to the TM for approval by DHAP Subtask 4.5. Parameterize the Resource Allocation Model according to the approved data definition document.

Subtask 4.6. Submit the parameterized resource allocation model and all related coding to the TM and DHAP staff.

Task 5. Calibrate epidemic projections Subtask 5.1. Calibrate epidemic projections against published national data on HIV incidence, and published rates of HIV diagnosis, linkage to care, notification of test results, retention in care, timing of initiation of ART, adherence to ART and attainment of viral load suppression.

Subtask 5.2. Write a report documenting the calibration results and specify any necessary changes to the data inputs to be submitted to the TM and DHAP for approval Subtask 5.3. Upon approval from DHAP, update inputs in data definition document and in the parameterized Resource Allocation model Subtask 5.4. Submit a final data definition document to the TM and DHAP staff.

Task 6. Activate the Parameterized Resource Allocation Model Subtask 6.1. Run the Parameterized Resource Allocation Model to estimate optimal resource allocation to each facet of the test and treat cascade for all populations combined and for each task group.

Subtask 6.2. Write a report documenting these baseline results and submit it to the TM and DHAP staff.

Subtask 6.3. Present the baseline results to TM and DHAP staff to obtain feedback and gather sensitivity analysis scenarios from DHAP staff. The number of scenarios is contingent upon the uncertainty of data parameters determined in task 4.

Subtask 6.4. Incorporate feedback into sensitivity analysis scenarios, including ranges and justifications Submit plan for sensitivity analyses to TM for approval.

Task 7. Sensitivity Analysis Subtask 7.1. Conduct sensitivity analysis based on the approved scenarios. Write a report documenting the sensitivity analysis results to be submitted to the TM and DHAP staff.

Subtask 7.2. Discuss sensitivity analysis results with DHAP to gather any additional scenarios required.DHAP will determine which scenarios to highlight in the manuscript for publication.

Task 8. Analysis of Parameterized Resource Allocation Model Subtask 8.1. Write a draft manuscript describing the analysis of the cost-effectiveness of enhancing the steps of the test and treatment cascade to be provided to the TM and DHAP staff for review. Manuscript must be suitable for publication in top tier peer-reviewed journal.

Subtask 8.2. Incorporate feedback and send a final draft manuscript to the TM and DHAP staff for approval.

Task 9. User Guides Subtask 9.1 Technical users guide to be submitted to the TM and DHAP staff for review and approval Subtask 9.2. Incorporate feedback and submit a final user’s guide and technical user’s guide to the TM and DHAP staff.

V. Reporting Requirements:

The contractor shall provide the following reports to the Technical Monitor:

(a) Monthly Reports:

A monthly progress report that contains at a minimum, the following information: a brief description of requirements, accomplishments during the reporting period and significant events regarding the task order, deliverables submitted, progress on deliverable products, any current and anticipated problems and solutions proposed stakeholder participation and issues, communications with persons, groups, organizations, and agencies and the nature of those communications, activities scheduled for the next month, and key personnel changes and a brief summary of activity planned for the next reporting period.

(b)Conference Calls The Contractor shall have at least 2 conference calls per month with the TM to discuss progress, problems and solutions. Models and data shall be presented electronically via web based presentations or teleconference as determined by the TM.

(c) Final Project Report

The Contractor shall submit a draft report to the technical monitor 2 weeks before the end of the project summarizing the project and its findings in narrative and figurative format. The Technical Monitor will respond with comments on the draft final report within ten (10) working days of its receipt.

VI. Deliverables:

The contractor shall furnish the CDC Project Officer and Technical Monitor the following items in the quantities and during the time periods indicated. All documents to be in Microsoft Word © or other format, as specified by CDC.

Task/Subtask

Draft end user’s guide Draft technical user’s guide

Final end user’s guide Final technical user’s guide

VII. Special Considerations

1. During or after the life of this task order, the contractor shall not release any data, publications or materials developed under this task order without prior CDC clearance and approval. CDC retains the rights to all data developed under this task order.

IX. Government Furnished Equipment:

All documents and background materials needed to accomplish the required tasks will be provided by the Government at the kick-off meeting and subsequent meetings between the Contractor and the Government.

X. Period of Performance:

Twelve months from date of task order award.

XI. Place of Performance

The Contractor’s Facility