Draft SOW for CISS Injury Coding Center.pdf

Request for Proposal: TBD Title: CISS Injury Coding

SECTION C – DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK (DRAFT)

C.1 BACKGROUND

The National Highway Traffic Safety Administration (NHTSA) is responsible for reducing the personal injury and property losses resulting from motor vehicle crashes. NHTSA relies on data to measure the characteristics and needs of the highway safety environment. Data is essential to reducing the human and economic cost of motor vehicle crashes. NHTSA has several different programs that collect real-world crash data that support research, identify potential problems among the fleet and roadways, aid in the development of effective countermeasures, provide a basis for rulemaking decisions, evaluate traffic safety programs, assess new technologies, and provide support for eventual NHTSA highway safety grants.

In the late 1970s, NHTSA’s National Center for Statistics and Analysis (NCSA) devised a multifaceted approach to meet NHTSA’s data needs that used a combination of census data, State reported data, and nationally representative traffic crash data of real-world crashes on a systematic and timely basis. NHTSA created two types of data collection efforts: records-based systems and crash investigation-based systems. The records-based systems involve the coding of crash data from crash records and includes the Fatality Analysis Reporting System (FARS) and Crash Reporting Sampling System (CRSS). The crash investigation-based systems include the Crash Investigation Sampling System (CISS), a program that studies real-world scenarios through in-depth crash investigations and subsequent coding of crash data into a central database, the Crash Data Acquisition Network (CDAN). The crash investigations are supplemented by an analysis of additional information, such as injuries sustained in crashes through an examination of medical records from hospitals and other healthcare providers. This data allows the Agency and other data users to have a standardized dataset to evaluate all aspects of crash-related data and make determinations on vehicle crashworthiness.

CISS consists of three (3) main data collection and processing elements: the CISS Primary Sampling Unit (PSU) Operations Center; the CISS Quality Control Center (QCC); and the CISS Injury Coding Center (ICC). The PSU Operations Contractor provides oversight to seventy-three (73) PSUs located throughout the contiguous United States (see Table 2). Each PSU collects and codes information from investigations into CDAN on a weekly basis. The investigations include detailed scene and vehicle inspections supplemented by interviews with crash victims. The data collected is amalgamated for clinical review within CDAN with detailed images for proper analysis. The CISS QCC provides comprehensive quality control reviews of the data collected by the seventy-three (73) PSUs. This process includes variable data reviews, examinations of vehicle and scene inspections, image reviews, and many other processes to ensure quality case data. The CISS ICC provides detailed assessments of occupant injuries in crashes produced in CISS. Key to this role is the evaluation and coding of medical record data, understanding of occupant kinematics (motion and movement of occupants) in crashes. and involved physical components (IPC) associated with injuries.

After the data is processed, NCSA prepares an annual data file for government and public distribution with statistical case weighting methods applied as well as a Crash Viewer for users to examine the cases clinically. The release of this data is predicated on all personal identifiers being removed from electronic files to protect the privacy of the individuals involved. The data provided by CISS, along with other data systems, provide the information necessary for NHTSA and other motor vehicle research organizations to identify safety problems, monitor trends, assess proposed standards and countermeasures, and evaluate those already in effect.

This contract is for the CISS Injury Coding Center aspect of this work. Table 1 represents the minimum staffing categories necessary to run the ICC. Table 2 represents the PSU locations included in the nationally representative CISS program. NHTSA will award one (1) contract for the Injury Coding Center task in CISS.

C.1.1 Staffing Requirements

Maintaining the quality coding of injuries in CISS cases and personnel working on the Injury Coding contract is paramount. The Contractor shall abide by minimum Engineering Technician category floors determined by the Department of Labor’s Wage and Hour Division’s for the Program Manager, Senior Injury Coder, Injury Coder, and Injury Registrar positions as outlined in Table 1 and Section C.4.1.4 below. Contractors are expected to maintain a minimum personnel (Senior Injury Coder/Injury Coder) to PSU ratio of one (1) to every seven (7) PSUs.

Table 1

Engineering Technician VI

(Program Manager)

Engineering Technician V

(Senior Injury Coder)

Engineering Technician IV (Injury Coder)

Engineering Technician III

(Injury Registrar) All Staff is full-time Labor categories are wage determinations under the Service Contract Act by direction of the U.S. Department of Labor.

C.1.2 Primary Sampling Unit Numbers and Locations

Table 2 PSU Number Location of PSU

1 Comal County, Texas 2 Henry and Rock Island Counties, Illinois 3 Carter County, Oklahoma 4 Monterey County, California 5 Berkshire County, Massachusetts 6 Atlantic County, New Jersey 7 Gallatin, Hardin, and White Counties, Illinois

8 Latah and Nez Perce Counties, Idaho Asotin and Whitman Counties, Washington

9 Butte County, California 10 Etowah County, Alabama 11 Chippewa and Eau Claire Counties, Wisconsin 12 Hamilton County, Ohio 13 Cameron, Potter, and Tioga Counties, Pennsylvania 14 Maricopa County, Arizona

15 Dallas County, Texas 16 Cumberland County, Maine 17 San Bernardino County, California

18 Bristol County, Massachusetts Newport County, Rhode Island

19 Delaware and Morrow Counties, Ohio 20 Nassau County, New York 21 Montgomery and Preble Counties, Ohio 22 Tarrant County, Texas 23 Sacramento County, California

24 Chesterfield County, Virginia Hopewell City, Virginia

25 Carbon and Yellowstone Counties, Montana 26 Delaware and Greene Counties, New York 27 Dade and Lawrence Counties, Missouri 28 Vermillion and Vigo Counties, Indiana 29 Box Elder County, Utah 30 Franklin County, Alabama 31 Piscataquis and Somerset Counties, Maine

32 Albemarle and Greene Counties, Virginia Charlottesville, Virginia

33 Passaic County, New Jersey 34 Mobile County, Alabama 35 Collin County, Texas 36 Fairfield County, Connecticut 37 Sebastian County, Arkansas 38 Spartanburg County, South Carolina 39 Davidson County, Tennessee 40 Haralson and Polk Counties, Georgia 41 Wayne County, Michigan 42 Broward County, Florida 43 Storey and Washoe Counties, Nevada 44 Cuyahoga County, Ohio 45 Harvey and Sedgwick Counties, Kansas 46 Los Angeles County, California 47 Cook County, Illinois 48 Jefferson County, Alabama 49 Bernalillo County, New Mexico 50 Tulsa County, Oklahoma 51 Dekalb County, Georgia 52 Hancock and Marion Counties, Indiana 53 Queens County, New York 54 Blount County, Alabama 55 Middlesex County, Massachusetts 56 Contra Costa County, California

57 Island and Snohomish Counties, Washington 58 Harris County, Texas 59 Vernon County, Louisiana 60 Genesee and Orleans Counties, New York 61 Jefferson and Leavenworth Counties, Kansas 62 Ramsey County, Minnesota 63 Clark County, Nevada 64 Allegany County, Maryland; Mineral County, West Virginia 65 Galveston County, Texas 66 Bibb and Chilton Counties, Alabama 67 Saint Charles County, Missouri 68 Christian and Macon Counties, Illinois 69 Clay, Lincoln, Turner, Union, and Yankton Counties, South Dakota 70 Jefferson and Wheeler Counties, Oregon 71 Lebanon County, Pennsylvania 72 Cowlitz and Lewis Counties, Washington 73 Blair County, Pennsylvania

C.1.3 Glossary of Terms and Abbreviations

Table 3 Abbreviation Definition AAAM Association for the Advancement of Automotive Medicine AIS Abbreviated Injury Scale CAP Contractor Acquired Property CDAN Crash Data Acquisition Network CDS Crash Data System CID Crash Investigation Division CISS Crash Investigation Sampling System CO Contracting Officer COR Contracting Officer’s Representative CRSS Crash Report Sampling System CS Contract Specialist DOT Department of Transportation EMS Emergency Medical Service FAR Federal Acquisition Regulation FARS Fatality Analysis Reporting System GCS Glasgow Coma Scale GES General Estimates System GFE Government Furnished Equipment ICC Injury Coding Center ICS Injury Causation Scenario IPC Involved Physical Component MPR Monthly Progress Report MY Model Year

NASS-CDS National Automotive Sampling System - Crashworthiness Data System NASS-GES National Automotive Sampling System - General Estimates System NCSA National Center for Statistics and Analysis NHTSA National Highway Traffic Safety Administration NTS Not-In-Traffic-Surveillance ODI Office of Defects Investigation PCR Police Crash Report PSU Primary Sampling Unit PSU-OPS PSU Operations Center QCC Quality Control Center SCI Special Crash Investigation SS Special Studies SSR State Specific Report TSI Transportation Safety Institute VAID Visual Anatomical Injury Descriptor VIN Vehicle Identification Number

C.1.4 Definitions of Relevant CISS Program Terms

The Crash Data Acquisition Network (CDAN) houses the computer-based applications the CISS program uses for the processing cases derived from the Crash Technicians at Primary Sampling Units (PSU). Crash Technicians are fully trained investigators that are assigned cases on a weekly basis to investigate at the PSU locations listed in Table 2. The cases are investigations that involve the inspection of vehicles (exterior, interior & safety systems) that have been involved in crashes, scenes where the crash occurred, interviewing of crash victims, and collection of supporting materials to generate thorough reconstructions of the crash events.

Within CDAN is the CISSWeb program. This program contains a listing of each crash and the relevant data to each case. This includes data on the results of vehicle investigations, crash scenes, crash reconstructions, electronic copies of official documents, images, and other data.

CISSWeb will be the platform the Contractor will use to satisfy most of the contract requirements. The Visual Anatomical Injury Descriptor (VAID) software is the injury coding program that uses the Abbreviated Injury Scale (AIS) anatomical-based coding system to classify injuries, assign IPCs, and specify the Injury Causation Scenarios (ICS) of each injury sustained in crashes. The Contractor will use this tool or something similar during this contract.

C.2 OBJECTIVES

The objective of this contract is to code the injuries sustained by occupants in crashes produced by the CISS program using the Abbreviated Injury Scale (AIS) anatomical-based coding system created by the Association for the Advancement of Automotive Medicine (AAAM) and link those injuries to vehicle and environmental sources in CISS cases. Cases are the product generated by the seventy-three (73) PSUs listed in Table 2. When fully operational, these PSUs produce approximately 9,500 cases a year.

C.3 GENERAL REQUIREMENTS

The Contractor shall code the injuries sustained by occupants in crashes produced by the CISS program, execute a cohesive program, and provide quality control support:

• To ensure timeliness, accuracy, consistency, and completeness in the coding of CISS medical-related data among all coding staff,

• To have or ability to gain knowledge in the CISS-based databases such as the Crash Data Acquisition Network,

• To be proficient and remain so in AIS methodologies, and

• To provide detailed feedback to the Quality Control Center to pass along to CISS Crash

Technicians on shortcomings of cases during quality control injury reviews.

C.4 SPECIFIC REQUIREMENTS

C.4.1 CISS Injury Coding

This task involves the coding of injuries sustained in crashes and the linking of those injuries to vehicle/environmental sources with data derived from cases selected by CISS PSUs and medical documents/records received from hospitals and other third parties.

The success of quality data coding is strongly dependent upon proper interpretation of data. The Contractor staff shall be thoroughly familiar with medical terminology, occupant kinematics, biomechanics, and NHTSA injury coding procedures and protocols. The injury coding responsibilities include but are not limited to the following:

1. Medical Record Collection –The Injury Coding Center (ICC) Contractor shall work collaboratively with the existing PSU Operations (PSU-OPS) Contractor and Quality Control Contractor (QCC). The names of these entities will be disclosed upon contract award. The ICC shall also assist in establishing and maintaining cooperation at medical facilities, hospitals, emergency medical services (EMS), medical examiners, and coroners servicing each PSU. The medical records will be obtained primarily by the PSU Contractor, with assistance from the ICC and QCC as requested.

2. Injury Interpretation and Code Assignment - The Contractor shall be responsible for the identification and interpretation of injuries from medical documentation and assigning injury codes based on the most recent version of the AAAM-AIS anatomical-based coding system. Other data associated with injuries such as the length of hospital stays, Glasgow Coma Scale (GCS) Score, and EMS information will be collected and entered by the Contractor. Injury information will be entered into CISS cases using a combination of VAID and CDAN CISSWeb software applications.

3. Injury Causation – The Contractor shall be responsible for examining the images and other documentation from the involved vehicle and selecting an Involved Physical Component (IPC) and Injury Causation Scenario (ICS) for each injury. Additionally, the contractor shall enter injury causation information such as body region injured, source of energy, contributing factors, and comorbidities.

4. Medical Record Storage – The Contractor shall be responsible for the secure storage of medical records until permission is granted from COR for disposal. Disposal procedures will be articulated to the Contractor by the COR after the award date.

5. Special Studies – In addition to the standard CISS data collection, NHTSA may design and implement special study data collection programs at various times. These special studies will involve additional data collection activities for a set time. These may include the additional collection of medical documents/records and require injury coding. Special Studies are discussed in greater detail in Sections C.4.1.10 and C.4.1.11 below.

The injury coding process for each case shall be completed within four (4) weeks of the date the medical record and case data was released to the Contractor.

C.4.1.1 CISS Injury Coding Severity in CISS Cases

CISS cases vary in complexity based on many factors, including the crash severity, seat belt usage and safety systems available in vehicles. Similarly, the amount of time injury coders will spend on injury coding activities for CISS cases is typically, but not always, in line with the severity of crashes. Historical data indicates that 63-percent of CISS occupants require injury coding. The estimated breakdown on injury level severities in CISS cases based on historical data is illustrated in Table 41.

Table 4

Historical Annual Injury Severity Levels in Crashes

Max Injury Severity- Case K-Killed A-Incapacitating

Injury

B-Non- Incapacitating

C-Possible Injury O-No Injury Total

Projected sample allocation 5% 21% 42% 32% 100% Total CISS Cases 450 1,890 3,780 2,880 9,000 Projected cases with injury coding required 6,120 Projected occupants with injury coding required 9,792

Historical data is constrained to data using CISS cases and the types of crashes sampled for investigations retrospectively. Past CISS crash case selection was limited to crashes involving passenger vehicles less than 10,000 pounds. Three (3) additional crash types including non-motorist (e.g., pedestrian, bicyclists), motorcycle, and large vehicle (more than 10,000 pounds) crashes are going to be part of the sample in this contract. It is expected that that the number of cases with codable injuries will thereby increase the “63-percent of CISS occupants” baseline to

1 These estimates are based on 9,000 cases and can vary with fluctuations.

approximately 70-percent. Fatal and incapacitating injuries are expected to rise in proportion.

The Contractor should therefore estimate the time spent on cases with greater complexity to increase from 5-percent and 21-percent to approximately 8-percent and 24-percent, respectively.

This is illustrated in Table 5.

Table 5

Projected Annual Injury Severity Levels in Crashes

Max Injury Severity- Case K-Killed A-Incapacitating

Injury

B-Non- Incapacitating

C-Possible Injury O-No Injury Total

Projected sample allocation 8% 24% 42% 26% 100% Total CISS Cases 783 2,350 3,780 2,546 9,459 Projected cases with injury coding required 6,855 Projected occupants with injury coding required 9,792

C.4.1.2 Project “Kick-Off” Meeting

Within two (2) weeks after award, the Contractor shall meet with the COR, Contracting Officer (CO), and other interested NHTSA personnel in person or virtually through a web-based video conferencing platform. The Contractor shall present an overview of their management plan, program objectives, and quality control procedures. The purposes of the initial “Kick-Off” meeting shall be to:

• Review any contractual matters, including terms and conditions of the Contract;

• Review and discuss Section C.4 - Specific Requirements of the Contract to ensure a common understanding of the general requirements; and

• Respond to any questions the parties may have.

C.4.1.3 Establish Injury Coding Facility

Within two (2) weeks of award, the Contractor shall establish an Injury Coding Center.

The ICC office space shall be sufficient to accommodate staff members as well as provide space for processing and storing of medical record documentation. The office space shall include a climate-controlled area for computers and other environmentally sensitive hardware, which may be used in the future. A dedicated computer line shall be established for computer communications. The Contractor is responsible for installation of communication lines (if not already installed) to connect to the wide area network used for the electronic data collection system. The Contractor is responsible for installation of communication lines to connect to the wide area network used for the electronic data collection system and high-speed internet and (backup) mobile connectivity as specified in Attachment J.2, CDAN Requirements.

The Contractor shall acquire [purchase, rent, lease, or receive as Government Furnished Equipment (GFE)] and maintain the facilities, equipment, and supplies needed to accomplish this work. Within six (6) months of Contract award, the Contractor shall prepare a Form HS 324 listing all property valued over $500.00 acquired for use under this contract and submit that form to NHTSA. The COR shall be consulted before major equipment is acquired to ensure its suitability and best source for supplies. Prior to making any equipment acquisitions over $500.00, the Contractor shall request and receive approval from the CO and the COR.

C.4.1.4 Establish Injury Coding Staff

Within two (2) weeks of Contract award, the Contractor shall hire staff for the ICC. All proposed management and technical personnel shall be thoroughly familiar with NHTSA injury coding conventions. If an Offeror submits a proposal that includes untrained and inexperienced personnel that will require CISS Basic Training, they shall add an additional $125,000 for each untrained staff member to the Price Schedule (B.2), since these additional costs will ne necessary to train such individuals.

C.4.1.4.1 ICC Program Manager

The Contractor shall appoint one (1) Project Manager (PM). The PM shall have experience in the management of in-depth crash studies and have an educational background in the fields of engineering, behavioral or physical science, or business (systems) management, or something commensurate.

C.4.1.4.2 ICC Senior Injury Coders

The Contractor shall obtain personnel to serve as Senior Injury Coders. Senior Injury Coders should have at least five (5) years’ experience identifying injuries from medical records and coding those injuries using the AIS or have commensurate experience. They should be experienced in all aspects of in-depth crash investigations, clinical evaluations, and crash reconstruction. Senior Injury Coders should demonstrate cross sectional experience in human anatomy, vehicle damage analysis, mechanisms of injury, injury coding, and occupant kinematics or something similar. Senior Injury Coders should be certified or trained by the AAAM in AIS coding or have participated in previous NHTSA Injury Coding training sessions. If this is lacking the Contractor shall propose a plan to quickly establish these personnel standards.

Senior Injury Coders shall work full time on this contract and be identified in Section G.5 – Key Personnel.

C.4.1.4.3 ICC Injury Coders

The Contractor shall obtain personnel to serve as Injury Coders. Injury Coders should have at least one (1) year of experience identifying injuries from medical records and coding those injuries using the AIS or similar injury classification system. Injury Coders should demonstrate cross sectional experience in human anatomy, mechanisms of injury, and occupant kinematics.

Commensurate experience for both C.4.1.4.2 and C.4.1.4.3 will be considered on a case-by-case basis.

C.4.1.4.4 Registry/Administration

The Contractor shall obtain one (1) staff member to serve in the case registry and administrative processes in support of the PM. Registry involves the initial receipt of the cases submitted by PSUs and distribution to other personnel under the direction of the PM through the levels of injury review.

Administrative functions include the onboarding of new staff, the PIV process, mandatory annual training adherence, and inventory management.

Commensurate experience for C.4.1.4.2 - C.4.1.4.4 will be considered on a case-by-case basis.

C.4.1.5 Cooperation of Local Medical Facilities

One of the most important responsibilities is the establishment and maintenance of medical facility cooperation. The Injury Coding Contractor shall work collaboratively with the CISS PSU-OPS Contractor in determining medical facilities servicing the PSU. The medical facilities may include trauma centers, hospitals, emergency medical services (EMS), medical examiners, and coroners.

Based on its mandate and mission, NHTSA meets the definition of a public health authority under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. As such, NHTSA has statutory authority to collect information and conduct research related to the control and prevention of transportation-related injury, disability, and death.

Within one (1) month after contract award, the Contractor shall conduct a conference call with the PSU Operations PM to discuss cooperation at medical facilities servicing the PSU. Of particular importance are detailed instructions on the privacy policy and various methods that can be used to obtain medical data such as report templates and coding schemes to sanitize hospital records. The Contractor shall also review the Area Documentation documents on CDAN/Shared Space and assist in maintaining cooperation with existing partners and establishing cooperation with new ones as new PSUs are opened.

The Contractor shall assist the CISS PSU-OPS Contractor and NHTSA in establishing agreements to obtain medical records from local medical facilities, with the CISS PSU-OPS contractor paying a fee if necessary. Electronic medical record information is the preferred means of collection;

however, if necessary, paper copies of medical records may be used. If possible, agreements with medical facilities shall make medical records available without patient releases.

C.4.1.6 Medical Record Collection

The Injury Coding Contractor must work collaboratively with the PSU-OPS Contractor to maintain cooperation with medical facilities servicing the PSU. Requesting and obtaining medical records from these medical facilities will be a collaborative effort led by the PSU-OPS Contractor, with the assistance of the ICC.

The consistency of the medical documentation collected from the various medical facilities shall be as uniform as possible to ensure robust injury causation coding. Receipt of occupants’ initial triage records, discharge summary, radiologic reports, procedure/operative reports, and the admitting review of systems (ROS) or “history and physical” is the desired baseline minimum for documentation on all significant injury cases. To improve AIS coding and the understanding of injury mechanisms, the collection of radiologic images is desired. Additional cooperation and costs may be associated with the collection of radiological images either in the electronic format typically provided to the patient or by Digital Imaging and Communications in Medicine (DICOM) format downloaded from the Picture Archiving and Communication Systems (PACS) at the medical facility of record. Provisionally, this additional information (e.g., medical imaging) may be used to support enhanced injury coding for all AIS 3+ injuries.

For fatal cases where the occupant did not reach a medical facility for diagnostic procedures, a complete internal autopsy shall be the desired baseline for documentation. Some medical examiners/coroners utilize computed tomography (CT) scans or radiologic imaging on fatal occupants that did not receive sufficient diagnostic procedures to document injury in lieu of an internal autopsy. In cases where this occurs, the radiologic report of the CT scan shall be the minimum baseline documentation collected.

C.4.1.7 Injury Interpretation and Code Assignment

The medical records and other case data including police crash reports, coded vehicle and occupant data, vehicle images, scene diagrams, and some interviews will be made available to the Contractor by electronic means in the CISSWeb application. The Contractor shall be responsible for the identification and interpretation of injuries from medical documentation and assigning injury codes based on the most recent version of the AIS available to NHTSA. The AIS codes shall be entered into VAID, or similar injury coding software, provided by NHTSA.

Other data associated with injuries such as hospital stay, vital signs, Glasgow Coma Scale (GCS) score, comorbidities, and EMS information will be collected and input into the CISSWeb or similar application by the Contractor. The injury coding process for each case shall be completed within four (4) weeks of the date the medical record and vehicle data was released electronically to the Contractor.

C.4.1.8 Injury Causation

The Contractor shall be responsible for examining images and other documentation from the vehicle and occupant and selecting one or more involved physical component(s) for every injury.

Multiple involved physical components may be coded in cases where more than one component is involved in the loading to the occupant (e.g., tandem components loading the body at a single anatomic location or two non-adjacent components loading the body at two separate anatomic locations). Other injury-specific data, including the body region injured, source of energy, contributing factors, injury mechanism, and confidence level, shall also be assigned for injuries of AIS severity 3 or higher and select AIS severity 2 injuries. The injury causation assignment process for each case shall be completed within six (6) weeks of the date the medical record and vehicle data was released to the Injury Coding Contractor.

C.4.1.9 Special Studies Injury Coding

The Contractor should anticipate that NHTSA will conduct special studies during the period of performance. NHTSA performs special studies on a specific area of interest, which involves data collection and review for a limited period. The number and duration will be based on the complexity of each special study, the size of the sample needed, and the system capacity at the time. Past examples of special study subjects include heavy truck underride crashes, side intrusion, rollovers, center high mounted stop lamps, anti-lacerative windshields, collisions with utility poles, crash cushions, child safety seats, longitudinal barriers, tire pressure, large truck crashes, crash avoidance, and severe injury crashes involving emergency transport to trauma centers.

If NHTSA performs a special study during the period of performance, the Contractor shall provide support to NHTSA by utilizing current ICC personnel or by hiring additional personnel for limited periods of time. The Contractor shall anticipate that approximately one such study may be conducted annually, and a five-day training will be required per occurrence. The Contractor shall plan for two (2) persons to attend a two-day meeting each year for the development and review of data collection activities for special studies; however, special studies are not conducted every year.

If exercised, the Government will advise the Contractor of its desire to exercise an Optional Task for Special Studies. The Government is not obligated to order these optional Special Studies tasks, nor is the Contractor obligated to perform these optional tasks unless a bilateral modification is executed between the Contractor and the Government. If the Government elects to proceed with these optional tasks, then the Contractor shall provide the Government with a technical and cost proposal for fulfilling those requirements. This may include adding additional permanent or temporary staff for undetermined timeframes. Upon agreement with the terms and conditions associated with the performance and estimated cost of the task(s), a formal bi-lateral modification shall be exercised by the Contractor and the NHTSA Contracting Officer.

C.4.1.10 Identification of Case Quality Issues

During the injury coding and injury causation reviews, the Contractor may encounter circumstances with case quality or elements in CISS cases which warrant further review by the QCC. Examples would include incorrect interpretation of vehicle dynamics, principal direction of force, occupant contacts, intrusions, seat belt usage, or other areas. In instances where potential issues in the case are identified by Contractor personnel, the ICC shall notify the QCC and return the case electronically to the QCC Contractor for additional quality control or corrections.

C.4.1.11 Injury Coding Center Quality Control

Within four (4) weeks of award the Contractor shall submit to the COR a Quality Assurance Surveillance Plan (QASP) to outline the steps used to ensure quality control of injury coding including the methodology for case consistency between different members of the contractor’s staff.

The success of quality injury coding is dependent upon proper interpretation of data and establishing a formal review process. The Senior Injury Coders shall serve as the primary injury coding and injury causation reviewer, spending approximately half of their total hours reviewing cases completed by the other injury coding personnel. The Senior Injury Coders shall work full time on the CISS injury coding project. Select serious or complex injury cases, primarily defined as those with AIS severity of 3 or higher, which require additional oversight and expertise, shall be reviewed via web conference with NHTSA staff on a periodic basis. The entire review and coding process shall be completed within six (6) weeks of the date vehicle and medical record data was released to the Contractor.

C.4.1.12 NHTSA Field Crash Investigator Training (FCIT)

The Contractor shall attend an annual training workshop, currently termed the Field Crash Investigator Training (FCIT). The Contractor shall have their entire staff attend the workshop and assist in the training of crash technicians during the fieldwork (actual hands-on training in the field) aspects of the training and conduct presentations on topics agreed upon in advance of the workshop when requested by NHTSA. The training will focus on new or changing data elements and requirements to enhance the data set, changes in field procedures, new and/or modified investigation techniques, case review topics, quality control enhancements, and improvements and any areas that have been deemed problematic. The Contractor shall submit topics for an agenda to the COR four (4) months prior to the workshop. This training is typically held in early December in Orlando, Florida, or a location to be determined and is for one (1) full week [five (5) days]. Offerors should also include an annual three-day trip to Washington D.C.

for training of all staff members.

C.4.1.13 CISS Advanced Training

The Contractor may be required to provide advanced training to PSU staff. NHTSA has historically conducted two (2) advanced training courses during the contract performance period.

The Contractor should expect to have three (3) members of the ICC staff participate in these trainings. NHTSA may also require that the Contractor staff provide certain aspects of training during these courses.

C.4.1.14 Transition Requirements

During contract transition, the Contractor may relinquish responsibility for the ICC while another assumes that responsibility. The Contractor shall ensure that the transition of responsibilities is accomplished as quickly and effectively as possible (estimated to be thirty (30) days). It is crucial that injury coding activities are maintained during this period to protect the accuracy of the analysis file. If the responsibility for ICC is relinquished, the Contractor shall cooperate with the successor contractor during the transition period. All pertinent files and documentation that have been developed shall be shared with the successor and the COR. Prior to the end of the period of performance, all government furnished equipment with a full inventory shall be transferred to the new contractor.

(End of Section C)