Medical_Services_SOW_2018-2019.docx

Statement of Work- Corporate Medical Membership- Access

STATEMENT OF WORK

A. GENERAL INFORMATION

1. Title of Project: Corporate Medical Membership-Access

2. Scope of Work: The contractor shall act as a 3rd party to provide all resources necessary to any Federal Emergency Management Agency (FEMA) employee(s) (or any member who FEMA has declared to be on work related assignment on behalf of FEMA) on official travel with quality health care, medical and security assistance services within the Pacific Islands and/or territories (excluding Hawaii) should an incident arise. Contractor shall coordinate services for a maximum of 215 employees in one membership year. The average trip length is 30 days and will not exceed 120 days.

Contractor shall arrange any of the following 3rd party services, if needed:

Medical Services

· Emergency evacuation

· Medically-supervised repatriation

· Companion ticket

· Additional travel and accommodation arrangements after medical evacuation

· Repatriation of mortal remains

· Return home of minor children

· Medical monitoring

· Inpatient admission and identification of receiving physician

· Dispatch of medication and medical supplies

No Additional Fee

· Emergency and routine medical advice

· Pre-trip information on travel health issues

· Medical and dental referrals

· Outpatient referrals

· Outpatient case management

· Insurance claims assistance

· Outpatient medical expense guarantee and payment, upon approval

· Inpatient medical expense guarantee, cost review and payment

Travel Services

· Ground transportation and accommodations for accompanying family members

· Emergency personal cash advances

No Additional Fee

· Legal referrals

· Emergency message transmission

· Translations and interpreters over the phone

· Lost document advice

3. Background: FEMA Region IX’s Area of Response (AOR) includes the Pacific Basin, specifically Guam, American Samoa and the Commonwealth of the Northern Mariana Islands (CNMI). Employees proceed on official travel to this AOR on a regular basis providing support and assistance. In the event of an emergency, employees throughout FEMA, from various locations in the United States, would be deployed to this region. Should the need arise, due to the Pacific’s geographic isolation, requesting and receiving medical services/advice from the travelers Continental United States based insurance company/medical provider is not possible; hence the need for a 3rd party International service provider.

4. Performance Period: The contractor shall provide membership services to be available 24 hours a day/ seven days per week during the period of performance:

Base: Date of award through 1 calendar year Option Period 1: Date of award through 2 calendar years Option Period 2: Date of award through 3 calendar years Option Period 3: Date of award through 4 calendar years Option Period 4: Date of award through 5 calendar years

Estimated start date: June 13, 2018

Contractor is required to contact designated Region IX Medical Assistance Authorizing Person (AP) to verify FEMA employee or volunteer eligibility before any services are rendered. Contractor shall provide a best estimated cost of services and continue to update AP on employee status and need for additional service.

5. Type of Contract: Membership renewal fee is Firm-Fixed-Price. Services arranged by contractor are Cost-Reimbursement and will be issued via modification or order on a sole source basis at the time of the evacuation.

B. GENERAL

The AP is the representative identified to act on behalf of FEMA in the event there is a medical or security emergency involving an employee on official travel. Contractor must be able to contact one of the APs at all times. APs are always called for financial authorization prior to SOS performing a billable service as to not violate Appropriation Laws.

Throughout the course of the case, Contractor shall provide routine updates to the AP keeping him/her fully informed of the status and progress of events.

AP may be called by Contractor for advice on how your organization would like a case handled. Contractor may provide details of the situation and outline questions with which we need assistance. AP can initiate Emergency Services by calling Contractor.

C. STATEMENT OF WORK

1. Contractor shall contact the AP verify FEMA employee via names and last four digits of social security number

2. Contractor consults with the treating doctor to determine the patient's medical condition

3. Contractor considers the options and decides on the best course of action

4. Contractor shall advise AP of the recommendations, and obtain financial authorization

5. Evacuations are recommended if the patient has a serious medical condition and local facilities are inadequate

6. Repatriations are recommended if the patient requires follow-up medical care in his/her home country and will need medical assistance for his/her trip home

7. The following information shall be given to the AP:

· Destination of the nearest appropriate care facility

· Mode of transportation required

· Medical team and equipment required to safely transport the patient

· When the evacuation or repatriation should occur

· Estimated cost

8. As arrangements are made, contractor shall:

· Assist with the patient's official documents (passport, exit document, exit taxes, etc.)

· Notify the Authorized Person(s) of the complete evacuation schedule

D. CHANGES TO STATEMENT OF WORK

Any changes to this SOW or services rendered not approved by the AP, shall be authorized and approved only through written correspondence from the Contracting Officer (CO). A copy of each change will be kept in a project folder along with all other products of the membership. Costs incurred by the contractor through the actions of parties other than the AP or CO shall be borne by the contractor.

E. REPORTING REQUIREMENTS

The contractor shall advise AP of all services requiring financial authorization. Contractor shall provide all invoices to FEMA Finance Center.

F. GOVERNMENT RESPONSIBILITIES

· Signed Subscriber’s Declaration is due to contractor upon renewal of membership

· Membership fee is due to contractor at the time of renewal

· One of the three identified APs is obligated to be available to contractor in order to verify FEMA employees in need of contractor services

· Reimburse contractor for all AP approved 3rd party provided services in accordance with the Prompt Payment Act

DELIVERABLES

Determination of patient’s medical condition

Determine best course of action

Contact AP to obtain financial authorization

Arrange all 3rd party services

Continue to update AP on employee status and any changes in accrued costs