ATT008_SurvivorCCE_Template_StaffingandWages.xlsx
XLSX spreadsheet 26 KB Posted
- Attached to
- Solicitation - World Trade Center Health Program - Survivor Clinical Center of Excellence
- Solicitation number
- CDC-75D301-01-Solicitation-WTCHP
About this file
This file is a quarterly staffing report template for the World Trade Center Health Program Survivor Clinical Center of Excellence contract. The template requires comprehensive reporting of all staff performing work for the contractor, including full-time employees, new hires, and subcontractors. The report must detail each employee's start date, facility, activity codes corresponding to specific Performance Work Statement (PWS) sections, labor categories, salary, and percentage of effort.
The template provides an extensive list of activity codes mapped to specific contract requirements, including transition services, contract management, staffing requirements, stakeholder engagement, member services, health benefit administration, comprehensive care management, claims submission, data management, continuity of operations, and regulatory compliance. Labor categories range from administrative roles like Administrative Assistant to clinical positions such as Nurse, Physician, and Social Worker. The template is designed to ensure detailed tracking and reporting of personnel supporting healthcare services for 9/11 Survivors in the New York Metropolitan Area, aligning with the Centers for Disease Control and Prevention's World Trade Center Health Program requirements.
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Text version
Report_Template Quarterly Staffing Report for Option Period: XXXX Dates (xx/xx/xx - xx/xx/xx)
| Contract #: (enter contract number) Fringe Rate_______ Approved FTE_____ | ||||||||||
| Note: List vacancies at the top of the spreadsheet, followed by New Hires in Red text, and list subcontractors at bottom of spreadsheet | ||||||||||
| Start Date | Vacancy Date | Facility | Activity Codes | WTC Billing Labor Category | Employee Name | Sub-Contractor (Y/N) | Salary | % of Effort | Comments | |
| 0 |
Reference Instructions: Per Section 4.3 of the PWS, all staff performing work on behalf of the Contractor (including staff who are paid exclusively through fee-for-service work) shall be included on this report. The "Activity Codes" column must reference PWS sections, excerpted below for your reference. The "WTC Billing Labor Category" column must reference the labor categories utilized by the Contractor from the list of Program-approved billing labor categories, excerpted below for your reference (also provided as a standalone document in Attachment 006 of the solicitation).
| Activity Code | WTC Health Program Billing Category |
| 4.1 Transition-Related Services | Administrative Assistant |
| 4.1.1 Kickoff Meeting | Administrative Coordinator |
| 4.1.2 Transition-In | Benefits Coordinator |
| 4.1.3 Readiness for SHCD | Case Management |
| 4.1.4 Sustainment | Claims/Billing Manager |
| 4.1.5 Transition-Out | Claims/Billing Specialist |
| 4.1.5.1 Claims Runout | Clinic Manager |
| 4.2 Contract Management | Data Analyst |
| 4.2.1 Change Control Process | Deputy Director |
| 4.2.2 Project Management | Director |
| 4.2.3 Risk and Issue Management | Finance Specialist |
| 4.2.4 Cost Tracking and Invoicing | Information Technology |
| 4.2.5 Subcontracting | Medical Assistant |
| 4.2.6 Quality Assurance | Medical Records Coordinator |
| 4.3 Staffing Requirements | Member Services Coordinator |
| 4.3.1 Internal Provider Licensing and Insurance | Member Services Manager |
| 4.3.2 Training | Nurse |
| 4.3.2.1 Provider Education | Nurse Manager |
| 4.4 Stakeholder Engagement and Communications | Pharmacist |
| 4.4.1 Outreach and Education | Physician |
| 4.4.2 Member Services Administration | Physician Assistant |
| 4.4.3 Communications Products | Project Coordinator |
| 4.4.4 Handling of Returned Mail | Psychiatrist |
| 4.4.5 Consultation and Coordination with Program Stakeholders | Psychologist |
| 4.5 Member Services | Pulmonologist |
| 4.5.1 Member Enrollment and Disenrollment | Quality Assurance |
| 4.5.2 Member Retention | Social Worker |
| 4.5.3 Member Transfer Facilitation | Other |
| 4.5.4 Coordination of Benefits (COB) Facilitation | |
| 4.5.5 Disruptive Member and Member in Crisis | |
| 4.5.6 Benefits Counseling | |
| 4.5.6.1 Assistance with Obtaining Minimum Essential Coverage (MEC) | |
| 4.5.6.2 Assistance with Workers’ Compensation and other Healthcare Benefits | |
| 4.6 Health Benefit Administration | |
| 4.6.1 Initial Health Evaluations and Annual Monitoring Exams | |
| 4.6.2 Diagnostic Services | |
| 4.6.3 Cancer Screening | |
| 4.6.4 Requests for Certification | |
| 4.6.5 Conditions that do not meet Certification Criteria | |
| 4.6.6 Medical Treatment for Certified Conditions | |
| 4.6.7 CCE Treatment Secondary Reviews | |
| 4.6.8 Pharmacy Services | |
| 4.6.9 Disability Evaluations | |
| 4.6.10 Telehealth Services | |
| 4.6.11 Member Records Requests | |
| 4.6.12 Research Facilitation | |
| 4.7 Comprehensive Care Management (Case Management and Care Coordination) | |
| 4.7.1 Medical Prior Authorizations | |
| 4.7.2 Treatment Referrals | |
| 4.7.3 Utilization Management (UM) | |
| 4.8 Claims Submission and Payment | |
| 4.8.1 Legally Allowable Fee Schedule | |
| 4.8.2 Billing for Health Plan Benefits | |
| 4.8.3 Coordination of Benefits (COB) | |
| 4.9 Data Collection, Management, and Reporting | |
| 4.9.1 Systems | |
| 4.9.2 Member Portal and Member Record Maintenance | |
| 4.9.3 Data Analytics and Reporting | |
| 4.9.4 Data and Information Exchanges | |
| 4.9.5 Data Integrity and Governance | |
| 4.9.6 Comprehensive Data Extract | |
| 4.9.7 Data Management Plan | |
| 4.10 Continuity of Operations and Disaster Preparedness | |
| 4.10.1 Member Care Continuity | |
| 4.10.2 Business Operations Continuity | |
| 4.11 Regulatory Compliance | |
| 4.11.1 HIPAA Compliance and Business Associate Agreement | |
| 4.11.2 Fraud, Waste, and Abuse (FWA) Prevention and Detection | |
| 4.11.3 Records Management | |
| 4.11.4 Contractor Performance Oversight and Auditing |
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