RFI_Update0001_12.13.22.pdf

REQUEST FOR INFORMATION (RFI)

UPDATE 0001 (12.13.22)

Agency/Office: HHS/HRSA/OAMP Contracting Office Location: 5600 Fishers Lane, Rockville, MD 20857 Reference Number: 75R60223R00003 Title: Technical Assistance for Long COVID Health Care Centers in Underserved and Vulnerable Populations NAICS Code: 541611 (Administrative Management & General Consulting Services) Response Date: 9:00 AM (EST), December 19, 2022

This Request for Information (RFI) is issued by the Health Resources and Services Administration (HRSA) for the purpose of planning and market research only; questions will not be entertained in response to this notice. A solicitation is not being issued at this time. This notice does not commit HRSA to issue a solicitation, nor does it restrict HRSA to a particular acquisition approach. Any information provided to HRSA as a result of this RFI, is strictly voluntary. Responses will not be returned, nor will HRSA reimburse respondents for the costs of preparing and/or submitting responses.

While the information obtained from RFI responses may be used for planning purposes, and/or in the development of an acquisition strategy or solicitation, there is no guarantee that any solicitations will result from this notice. Respondents are responsible for appropriately marking confidential or proprietary information contained in their responses.

BACKGROUND

The Health Resources and Services Administration (HRSA) is the primary Federal agency for improving access to health care by strengthening the health care workforce, building healthy communities, and achieving health equity. HRSA’s Bureau of Primary Health Care (BPHC) is responsible for the administration and oversight of the Health Center Program that supports over 1,400 health centers providing primary care to over 30 million people in medically underserved communities.1

Since the beginning of the COVID-19 pandemic, BPHC has ensured health centers receive the tools they need to protect their communities against and treat the COVID-19, particularly vulnerable populations disproportionately impacted by the pandemic. However, millions of individuals continue to experience prolonged illness from COVID-19, known as long COVID.

The Centers for Disease Control and Prevention (CDC) defines long COVID as the occurrence of new, returning, or ongoing health problems four or more weeks after an initial infection with SARS-CoV-2. Common symptoms include fatigue, dizziness, coughing and headache, and can

1 U.S. Department of Health and Human Services, Health Resources and Services Administration, Health Center Data and Reporting, available at https://data.hrsa.gov/tools/data-reporting/program-data/national potentially last for years.2 According to the CDC’s June 2022 Household Pulse Survey, out of the 40% of U.S. adults who have contracted COVID-19 thus far, almost 20% of those adults still report having long COVID symptoms.3 Additionally, long COVID exacerbates other chronic diseases and co-occurring conditions adding a burden to the health of patients. To help individuals access supportive services, the Biden-Harris Administration has prioritized enhancing high-quality care for patients with long COVID, especially for those disproportionately affected by the pandemic. A relationship between long COVID and chronic diseases does exist. Existing research on this topic suggests that Type 2 diabetes mellitus has a bidirectional relationship with COVID-19. The presence of diabetes can influence long COVID via various pathophysiological mechanisms. COVID-19 can add to or exacerbate tachycardia, sarcopenia (and muscle fatigue), and microvascular dysfunction (and organ damage) in patients with diabetes.7 Additionally, global research suggests that lipid metabolism disorders, obesity, and fatty liver disease, often linked with hepatitis C are risk factors for developing long COVID.8

PURPOSE

The purpose of this notice is to obtain information regarding qualified and capable vendors that are interested and available to perform technical assistance services to support the long-term effects of COVID using the ECHO-like model for Health Centers across the United States.

ECHO-like models engage clinicians and specialists in ongoing distance learning communities to present real cases for discussion and recommendations. These models foster continuous learning, peer support, mentoring and allow participants to test and refine their knowledge (https://hsc.unm.edu/echo/what-we-do/about-the-echo-model.html).

The objective is to support the Health Center Program using the ECHO-like model to determine the overall burden of long COVID and its relationship to other chronic diseases, such as pre-existing Type 2 diabetes, overweight/obesity, metabolic-associated fatty liver disease (MAFLD), and Hepatitis C, often linked with non-alcoholic fatty liver disease (NAFLD) in the patient population and responding to the needs of communities impacted. In any given period, long COVID may be responsible for up to 1 million people being out of the workforce.4 In addition, if this project is not funded HRSA will not be able to provide additional support to health centers and their communities for primary care issues and the prevention and management of chronic conditions, including neurological symptoms, joint/muscle pain, heart conditions, and digestive symptoms.5 Without sufficient support, health care providers will continue to feel burdened by the lack of resources and services needed to care for long COVID and other chronically ill patients in their communities, especially those who may already be overwhelmed by the number

2U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Long COVID or Post-COVID Conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html. Last updated July 11, 2022.

3 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Nearly One in Five American Adults Who Have Had COVID-19 Still Have “Long COVID”.

https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220622.htm. Published June 22, 2022.

4 U.S. Government Accountability Office. Science & Tech Spotlight: Long COVID | U.S. GAO. Published March 2, 2022.

5 The Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art- 20490351#:~:text=But%20some%20people%20%E2%80%94%20even%20those,%2D2%20infection%20(PASC)..

https://hsc.unm.edu/echo/what-we-do/about-the-echo-model.html https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220622.htm https://www.gao.gov/products/gao-22-105666 of COVID-19 cases present. In particular, the pandemic's disproportionate impact on medically underserved communities will be further exacerbated.

Specifically, HRSA requests that respondents provide information about whether they have knowledge of such datasets, have current datasets, and capable of obtaining these datasets and performing technical assistance services in the categories listed below. In addition, HRSA requests information about any capabilities that respondents may have to better support technical assistance services in the task areas listed below, and experience with supporting these efforts specific to the impact and improvement related to underserved communities nationwide.

The period of performance for this effort shall be a one (1) year Base Period and two 12-month Option Periods. It is anticipated any resultant contract will be issued on a Firm-fixed Price (FFP) basis.

RESPONSES

In response to this notice, HRSA is seeking capability statements from businesses who can demonstrate experience, expertise, and capability to perform the following tasks:

• Project Work Plan o Method and criteria used for the outreach and recruitment of 100 health center organizations and their providers to participate in the program, development of selection criteria that reflects the variety of populations that health centers serve across the nation, and the review processes applied for assessment and final section. The method and criteria shall include the following:

Specific plan to recruit a provider team for each health center. At a minimum, provider teams will have a lead clinician (i.e., physician, nurse practitioner, or physician's assistant) and a nurse or medical assistant.

Take into consideration how to most effectively reach vulnerable and underserved populations served through the Health Center Program.

Strategy to identify health centers that treat populations with pre-existing Type 2 diabetes, overweight/obesity, metabolic-associated fatty liver disease (MAFLD), and Hepatitis C, often linked with non-alcoholic fatty liver disease (NAFLD).

o Description of Subject Matter Specialists that will facilitate distance-learning clinics and deliver didactic presentations o Description of Collaboration and/or Partnership efforts with:

National entities incorporating continually evolving long COVID and chronic disease knowledge into current best practices and policies Academic and research and teaching hospitals and institutions Community-based organizations with demonstrated expertise and experience working with medically underserved communities, communities disproportionately impacted by COVID-19, and/or communities with individuals directly experiencing long COVID symptoms o List of ECHO-like sessions by topic to be addressed o Engagement plan that measures the burden that this initiative would have on an already stretched health center workforce and outlines a variety of engagement strategies to ensure maximum participation o Address no engagement, low engagement, and disengagement o Projected timeline across the performance period with identified milestones to demonstrate progressive advancement of learning and application from learning.

o Identification of SMART (specific, measurable, achievable, relevant, and time-bound) goals and the manner in which advancement toward goals can be assessed using both quantitative and qualitative methods.

• Implementation of a Technical Assistance Model o Component 1: Pre- and Post-Assessments

Pre-project assessment to understand participating health centers’ current knowledge, skills, and capacity to diagnosis, treat, and manage long COVID and the concurrent management of pre-existing Type 2 diabetes, overweight/obesity, metabolic-associated fatty liver disease (MAFLD), and Hepatitis C, often linked with non-alcoholic fatty liver disease

(NAFLD).

Post-project assessment to demonstrate any change in pre-project assessment results; and

Evaluative measures to assess how effective the ECHO-like model was at improving the diagnosis, treatment, and management of long COVID and chronic diseases for patients at HRSA-supported health centers.

o Component 2: Routine Training and Technical Assistance Initial overview learning module to establish baseline knowledge of post-

COVID-19 conditions and the relationship with chronic disease and establish a shared starting point.

Biweekly 90-minute distance learning clinics (4 cohorts of 25 health centers each) allowing the 100 health centers to:

• Participate in peer-to-peer engagement and present patient cases (including medical histories and current treatment plans) and ask questions from other providers and specialists to receive feedback and recommendations.

• Expand providers’ knowledge, skills, and self-efficacy in caring for patients with long COVID and chronic diseases and developing policies, clinical workflows, and standards of care. to

Specialist-led didactic presentations to supplement distance learning clinics

Technical Assistance shall include:

• Appropriate prescribing of medications and treatments and appropriate referrals to specialists;

• Treatment guidelines and protocols, including clinical quality and safety and supporting the patients’ own medical management, and review of best practices for caretakers of long COVID patients, and care coordination strategies for patients to achieve and sustain recovery;

• Engagement with community partnerships to ensure comprehensive care

• Assessment of current clinical and public health recommendations, including emerging information relevant to long COVID care and management;

• Enhancement of the clinical and operational workflows;

• Incorporation of new technologies or enhancements in models of care to improve the effectiveness of long COVID services and increase patient engagement.

• Inclusion of long COVID-related comorbidities and vulnerable populations;

• Inclusion of long COVID and pre-existing comorbidities and vulnerable populations;

• Implementation of evidence-based practices to identify symptoms and diagnose long COVID; and

• Utilization of assessment tools to evaluate patients and severity of condition o Component 3: Engagement An engagement plan that identifies relevant information from the

ECHO-like model to disseminate widely to all HRSA-supported health centers. The Contractor shall package and disseminate materials that include but are not limited to briefings, data, training/technical assistance resources, emerging best practices, electronic newsletter, etc. to support all HRSA-supported health centers’ future work to address long COVID;

Ongoing creation of materials that allow for ECHO-like model replication at the health center-to-health center level (e.g, sample curriculum, recruitment strategies, etc.);

Ongoing creation and/or promotion of resources, information, and strategies to diagnose, treat, and manage long COVID and chronic diseases in a community health center; and

At minimum, biannual town hall, other virtual webinars, or broadcast materials for the larger Health Center Program audience to highlight emerging themes and best practices promising practices from health centers participating in the ECHO-like model.

• Monitoring, Tracking, and Reporting Requirements o Biweekly Monitoring Calls o Monthly Progress Reports o Technical Assistance Monthly Report o Annual Report

• Virtual Learning Community o Propose a virtual learning community that has a communication mechanism to disseminate and receive information through an email list-serve or other communication mechanism exclusively for all HRSA-supported health centers that shall receive technical assistance on long COVID. The Contractor shall ensure outreach to health centers and engage them in training and technical assistance activities, which may extend beyond distance learning clinics and didactic presentations. The Contractor shall incorporate up-to-date and scientifically backed research to support their training and technical assistance.

o Virtual Learning Community Plan - The virtual learning community plan shall include:

Provision of training and technical assistance on long COVID, including consultation with subject matter experts;

An overview of dissemination strategies and channels;

A designated channel where health centers can direct concerns, feedback, and questions relating to long COVID;

Response to technical questions from health centers as they relate to long

COVID; and Clean-up and maintenance procedures to ensure community is consistently updated.

o Technical Assistance/Training and Virtual Learning Community Participant

Feedback Summary Report Develop questions and use a survey mechanism to obtain feedback from participants of the training and technical assistance provided in the virtual learning community.

• Single Technical Assistance Resource o Develop a single ancillary resource for each ECHO, in a format to be discussed with the COR (checklist, quiz, one-pager, etc.) to be distributed among the 100 health centers, but also the broader health center community.

• Optional Tasks o Technical Assistance Sessions - Provide technical assistance sessions using the Project ECHO-like model to 25 health centers, as determined by the COR. These additional sessions will be virtual. This option may be exercised up to four (4) times during each contract year o White Paper - Draft a white paper, to highlight the relationship between long COVID and chronic diseases. This paper will ultimately be shared with the larger health center community. This task may be exercised up to 2 times during the period of performance.

RESPONSE DEADLINE & FORMAT

Interested parties are encouraged to respond to this notice. However, be advised that generic statements are not sufficient.

Please submit your responses by 9:00 AM (EST), December 19, 2022, to Gina Napier at gnapier@hrsa.gov, as follows:

Format

• Microsoft Word (or PDF) document with page size 8.5 by 11 inches, with a minimum of 1” margins.

• Times New Roman, font size 12 with single-spacing between lines.

• Submission shall not exceed fifteen (15) pages; cover page is not included in the total page count

Cover Page

• RFI Notice number, title, date of issuance

• Business name, address and point of contact phone and email

• Unique Entity Identifier (UEI) and NAICS code

Capability Statement

1) Include a list of the datasets and resources available from your organization to be used in performing required ECHO-like model tasks and technical assistance services

2) Include capability to perform ECHO-like model services of this magnitude and complexity, to include comparable work performed within the last five (5) years, a brief description of the work and/or contract numbers performed under, dollar value of comparable work, and customer satisfaction. If you were a subcontractor on a particular contract, please clarify the work that you did on that contract.

3) Include proposed contract-type and justification, if other than FFP.

4) Include Joint Venture information, if applicable.

5) Include interest in proposing to a subsequent solicitation, if issued.

Capability statements are not proposals and do not address actual cost or price details and information, other than structure. Interested parties are asked for information which proves that they have expertise and capacity to meet the requirements of this work. Respondents should provide enough information for HRSA to make an informed determination of their capability to perform the work. Respondents are requested to state their capabilities and expertise in clear and concise language.

mailto:gnapier@hrsa.gov

CONFIDENTIALITY

To the maximum extent possible, please avoid submitting confidential or proprietary information. Any confidential or proprietary information submitted shall be marked as such and will be protected from disclosure except as required by law. The Government reserves the right to use any unmarked information in any resultant solicitation(s).

DISCLAIMER & IMPORTANT NOTES

This notice does not commit the Government to award a contract or constitute an obligation of Federal funds. The Government reserves the right to use information provided by respondents for purposes other than those specified in this notice. The Government may not acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. Respondents will not be notified of the results of this market research.

Responses will not be returned.

NAICS Code: 541611 (Administrative Management & General Consulting Services)