Attach 1 - Performance Work Statement (PWS).pdf

Performance Work Statement (PWS) W912L3-20-R-2005

NON-CLINICAL CASE MANAGEMENT SERVICES

TABLE OF CONTENTS:

1. General:…………………………………………………………………………PP. 04-11 Section(s): 1.1 - 1.13

2. Definitions and Acronyms:…………………………………………………….PP. 11-13 Section(s): 2.1 - 2.2.50

3. Government Furnished Property, Materials and Equipment:………………PP. 13-14 Section(s) 3.1 - 3.6

4. Contractor Furnished Property, Materials and Equipment:……………………..P. 14 Section(s) 4.1 – 4.2

5. Contracting Personnel Performance Requirements:…………………….…..PP. 14-17 Section(s) 5.1 - 5.2.2

6. Applicable Publications:………………………………………………….....…PP. 17-18 Sections(s) 6 – 6.1

TECHNICAL EXHIBIT-1:………………………………………..………………..…PP. 19-20

TECHNICAL EXHIBIT-2:………………………………………….…………...……….P. 21

TECHNICAL EXHIBIT-3:………………………………………………………..……...P. 22

NON-CLINICAL CASE MANAGEMENT SERVICES

1. General:

1.1. Scope: The contractor shall provide all personnel, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to provide a wide range of Non-Clinical Case Management Services that include medical and dental non-clinical case management for the Wyoming Army National Guard (WYARNG).

1.2. Background: Non-Clinical Case Management Services are required to assess the medical readiness of Army National Guard personnel. The services required here in Wyoming typically do not require Registered Nurses to perform these duties as the requirement is strictly administrative. The mission of this service is to provide mechanisms for medical readiness administration for the Wyoming Army National Guard and the processing medical administrative documentation to ensure the highest levels of medical readiness and deploy ability for federal and state missions.

1.3. Period of Performance: The period of performance shall be one base of six months and one 12-month option year.

1.4. General Information:

1.4.1. Quality Control (QC): The contractor shall develop and maintain an effective Quality Control Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary (PRS). A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after contract award. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

1.4.2. Quality Assurance (QA): The Government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government will do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) or defect rate(s).

1.4.3. Recognized Holidays: The following are recognized US holidays. The contractor shall not perform services on these days:

1.4.3.1. New Year’s Day

1.4.3.2. Martin Luther King, Jr.’s Birthday

1.4.3.3. President’s Day

1.4.3.4. Memorial Day

NON-CLINICAL CASE MANAGEMENT SERVICES

1.4.3.5. Independence Day

1.4.3.6. Labor Day

1.4.3.7. Columbus Day

1.4.3.8. Veteran’s Day

1.4.3.9. Thanksgiving Day

1.4.3.10. Christmas Day

1.4.4. Place and Performance of Services: The contractor shall provide services between the hours of 0700 to 1630 on Monday through Friday, except for Alternate Work Scheduled approved by WYARNG, recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings.

1.4.4.1. Weekend Performance of Services: The contractor will be required to work one weekend per month (Saturday and Sunday). Service hours for these weekend requirements may be from as early as 0600 and as late as 2100. The COR will provide weekend Physical Health Assessment (PHA) schedule, to include date and location at least 30 days in advance of weekend duty.

1.4.4.2. The primary work site is the Joint Forces Readiness Center (JFRC) Complex 5800 Central Ave. Cheyenne, WY 82009. Travel to other sites may be required and will be addressed below in paragraph 1.12.

1.4.3. The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation.

Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times, and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance. The Government reserves the right to direct the removal of an employee for misconduct, security reasons, or any overt evidence of communicable disease. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

1.5. Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DOD), Headquarters Department of Army (HQDA) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

NON-CLINICAL CASE MANAGEMENT SERVICES

1.5.1. For contractors requiring Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential. CAC issuance requirements are as follows:

1.5.1.1. In accordance with Department of Defense Manual (Dom) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. The issuance of a CAC will be based on four criteria: (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 3, 2017, and (d) verification of a claimed identity.

Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID System (RAPIDS) using the DD Form 1172-2, or the Trusted Associate Sponsorship System (TASS).

1.5.1.2. HSPD-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them, and shall process all CAC card applications. The contractor shall ensure that all employees requiring an initial background investigation complete a Personnel Security Investigation Portal (PSIP) request form, OF-306 Declaration for Federal Employment, SF-312 Non-Disclosure Agreement and request for Background investigation for Non-military contractors at the earliest possible date and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward it to the National Guard Bureau (NGB) Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm that the investigative service provider has received the request, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e-QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the background investigation (BI) will be initiated. The contractor shall ensure immediate compliance with all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from two to six weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that contractor employees meet CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.

NON-CLINICAL CASE MANAGEMENT SERVICES

1.5.2. Trusted Associate Sponsorship System (TASS): The contractor shall process CAC applications through the TASS, the procedures for which are described below. Although there is no requirement for the contractor to designate a “Corporate Facility Security Officer" (FSO) to serve as its single point of contact for the BI, the TASS application process and other CAC and security-related matters, such designation facilitates these processes. If an FSO is not established, all contractor employees requiring a CAC will be required to process their own applications. The submission process for CAC applications is as follows:

1.5.2.1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA).

1.5.2.2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at: https://www.dmdc.osd.mil/tass/. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.

1.5.2.3. The Government will inform the contractor's applicant, via email, of one of the following:

1.5.2.3.1. Approval.* upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a RAPIDS station (RAPIDS Site Locator: http://www.dmdc.osd.mil/rsl/).

1.5.2.3.2. Rejection.* The Government, in separate correspondence, will provide reason(s) for rejection.

1.5.2.3.3. Return. Additional information or correction to the application required by the contractor employee.

*The contractor shall maintain records of all approved and rejected applications.

1.5.5. At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification. Identity source documents must come from the list of acceptable documents included in Form I-9, OMB No. 1615-0047, "Employment Eligibility Verification." Consistent with applicable law, at least one document from the Form I- 9 list shall be a valid (unexpired) State or Federal Government-issued picture ID. The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS, and will then issue a CAC. Issued CACs will be valid for no longer than three years, or until the individual's contract end date (inclusive of any options), whichever is earlier.

NON-CLINICAL CASE MANAGEMENT SERVICES

1.5.5.1. The contractor shall return issued CACs to the DEERS office upon departure or dismissal of each contractor employee, and shall obtain a receipt for each card and provide it to the TA/COR.

1.5.5.2. The contractor shall manage requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The contractor shall provide at least 10 calendar days advance notice to the TA, unless there are extenuating circumstances approved by the KO/COR.

1.5.6. The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a government computer network. This can be done by going to: http://www.us.army.mil and registering as an "Army Guest," with the sponsor being the COR or a COR- designated individual if the COR is ineligible to Serve as an AKO Sponsor. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.

1.6. Communications Security/Information Technology (COMSEC/IT) Security. All communications with DOD organizations are subject to communications security (COMSEC) review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DOD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DOD organizations. Therefore, the contractor is advised any time contractor place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DOD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

1.6.1. Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DOD strategy and their actions affect the most vulnerable portion of the AEI. Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall:

1.6.1.2. Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.

1.6.1.3. Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training https://informationassurance.us.army.mil).

1.6.1.4. Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.

NON-CLINICAL CASE MANAGEMENT SERVICES

1.6.1.5. Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.

1.6.1.6. Practice safe network and Internet operating principles and take no actions threatening the integrity of the system or network.

1.6.1.7. Protection of Personally Identifiable Information (PII). The contractor shall protect all Personally Identifiable Information (PII) encountered in the performance of services in accordance with DFARS 224.103 and DoDD 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals who’s PII has been compromised.

1.6.1.8. Maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines.

1.6.1.9. AT Level 1 Awareness Training (AT): All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete Level 1 AT within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee to the COR within 15 calendar days after completion of training. Level 1 AT is available at http://jko.jten.mil/courses/atl1/launch.html .

1.6.1.10. Information Assurance (IA)/Information Technology (IT) Training: All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DOD 8570.01-M shall be completed upon contract award.

1.6.1.11. Information Awareness: All contractor employees with access to a government information system shall be registered in the Army Training Certification Tracking System (ATCTS) (https://atc.us.army.mil/iastar/index.php) at commencement of services, and shall successfully complete the DoD Information Assurance awareness training prior to access to the IS and then annually thereafter. (https://ia.signal.army.mil/DoDIAA/).

1.7. OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each

NON-CLINICAL CASE MANAGEMENT SERVICES

contractor employee to the COR within 15 calendar days after completion of training. Once training is complete, contractors will adhere to WYARNG’s OPSEC Plan. COR will provide copy to all contractors.- Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.

1.7.1 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

1.8. Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO. The KO, Contracting Officer’s Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor performance. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.9. Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.10. Identification of Contractor Employees: Contractor employees will require contractor identification badges to be worn at all times in the performance of this contract. All contractor personnel attending meetings, answering Government telephones are required to identify themselves as contract employees to avoid creating an impression they are Government employees. The contractor shall ensure all documents or reports produced by contractor personnel are suitably marked as contractor products or contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities/ Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed. The contractor shall retrieve all identification media (including vehicle passes) from their employees who depart employment for any reason. All identification media (i.e., badges and vehicles passes) shall be returned to the KO/COR within 14 calendar days of an employee’s departure.

1.11. Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract;

procure commercial sex acts during the period of performance of the contract; or use forced

NON-CLINICAL CASE MANAGEMENT SERVICES

labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions will be taken against employees for violations of this policy. Such actions may include, but are not limited to, removal from the contract, reduction in benefits, or termination of employment. The Contractor shall take appropriate action, up to and including termination, against employees or subcontractors violate the US Government policy as described at FAR 22.17.

1.12. Contractor Travel: Contract employees may be required to travel to execute any missions to support and augment the Wyoming ARNG consistent with all services described within the PWS as shown below. Specifically, in the event of a mobilization or Physical Health Assessment (PHA) event, the Contractor shall ensure adequate Non-Clinical Case Management Services support is available for travel to locations to best support these activities (i.e. work at armories or CONUS Replacement Centers (CRC)) as directed by the KO. If changes to the original work in this PWS arise during the performance of the contract will notify the COR. If determined to be within the scope of the contract the KO will provide a 30 calendar-day notice to the contractor with full description of the need and request a proposal. The KO will negotiate a modification to the contract to provide this in-scope work effort. Travel to and from the primary work site will not be reimbursed.

1.13. Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO and in the event the KO unilaterally determines any such OCI cannot be satisfactorily avoided or mitigated, the KO may affect other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

2. Definitions and Acronyms

2.1. Definitions

2.1.1. Contractor. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2. Contracting Officer (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government.

Note: The only individual who can legally bind the government.

2.1.3. Contracting Officer's Representative (COR). An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide

NON-CLINICAL CASE MANAGEMENT SERVICES

technical direction to the Contractor as long as the direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4. Defective Service. A service output which does not meet the standard of performance associated with the Performance Work Statement.

2.1.5. Deliverable. A deliverable is anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.6. Key Personnel. Contractor personnel who may be required to be used in the performance of a contract as Key Personnel listed in the PWS.

2.1.7. Physical Security. Actions that prevent the loss or damage of Government property.

2.1.8. Quality Assurance. The government procedures to verify services being performed by the Contractor are performed according to acceptable standards.

2.1.9. Quality Assurance Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10. Quality Control. All necessary measures taken by the Contractor to assure the quality of an end product or service meets contract requirements.

2.1.11. Subcontractor. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.2 Acronyms:

2.2.1. AFARS Army Federal Acquisition Regulation Supplement

2.2.2. AR Army Regulation

2.2.3. AT/OPSEC Antiterrorism/Operational Security

2.2.4. CAC Common Access Card

2.2.5. CM Case Management

2.2.6. CFR Code of Federal Regulations

2.2.7. CONUS Continental United States (excludes Alaska and Hawaii)

2.2.8. COR Contracting Officer Representative

2.2.9. COTS Commercial-Off-the-Shelf

2.2.10. DA Department of the Army

2.2.11. DD250 Department of Defense Form 250 (Receiving Report)

2.2.12. DD254 Department of Defense Contract Security Requirement List

2.2.13. DFARS Defense Federal Acquisition Regulation Supplement

2.2.14. DOD Department of Defense

2.2.15. DSS Deputy State Surgeon

2.2.16. DM Disease Management

2.2.17. FAR Federal Acquisition Regulation

NON-CLINICAL CASE MANAGEMENT SERVICES

2.2.18. FMR Fully Medically Ready

2.2.19. GFP/M/E/S Government Furnished Property/Material/Equipment/Services

2.2.20. HBM Health Benefits Manager

2.2.21. HSS Health Systems Specialist

2.2.22. IA Information Assurance

2.2.23. IMR Individual Medical Readiness

2.2.24. IS Information System(s)

2.2.25. KO Contracting Officer

2.2.26. LOD Line of Duty

2.2.27. OCI Organizational Conflict of Interest

2.2.28. ODC Other Direct Costs

2.2.29. MEDPROS Medical Protection System

2.2.30. MHA Medical Health Assessments

2.2.31. MHS Military Health System

2.2.32. MM Medical Management

2.2.33. MODS Medical Operational Data System

2.2.34. MRDP Medical Retention Decision Point

2.2.35. PHA Physical health Assessment

2.2.36. PII Personally Identifiable Information

2.2.37. PIPO Phase In/Phase Out

2.2.38. POC Point of Contact

2.2.39. PoP Period of Performance

2.2.40. PRS Performance Requirements Summary

2.2.41. PWS Performance Work Statement

2.2.42. QA Quality Assurance

2.2.43. QAP Quality Assurance Program

2.2.44. QASP Quality Assurance Surveillance Plan

2.2.45. QC Quality Control

2.2.46. QCP Quality Control Program

2.2.47. RCAS Reserve Component Automation System

2.2.48. RN Registered Nurse

2.2.49. TE Technical Exhibit

2.2.50. UM Utilization Management

3. Government Furnished Property, Materials, and Equipment (GFP/M/E): Material, Equipment and Services (GFP/M/E/S): The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1. Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include desk space, telephones, computers and other items necessary to maintain an office environment.

3.2. Materials: Basic office supplies

NON-CLINICAL CASE MANAGEMENT SERVICES

3.3. Equipment: The government will provide required computers, scanners, telephones and materials necessary to comply with contract requirements at the job site.

3.4. Services: The contractors will be provided basic janitorial, waste collection, secure document disposal and other services to accomplish their duties outlined in PWS.

3.5. Utilities: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include desk space, telephones, computers and other items necessary to maintain an office environment.

3.6. Teleworking: Telework should be a no additional cost to the Government. If utilizing Gov't

When applicable, the contractor shall coordinate with COR for additional telework guidance.

4. Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.1. General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as required by the contract.

4.2. Secret Facility Clearance: Not required.

5. Contracting Personnel Performance Requirements

5.1 Key Personnel.

Key personnel assigned to this contract shall possess the required technical skills and expertise to perform the required tasks. Contactor personnel shall not perform inherently governmental functions (i.e., representation of government, decision authority). Key personnel shall have a working knowledge of military dynamics and organizational management.

5.1.1 Site Lead Case Manager.

5.1.1.1 The Contractor shall provide a Site Lead Case Manager located in Cheyenne, WY to serve as the lead point of contact over all contractor personnel. The Site Lead Case Manager ensures performance is in accordance with the PWS.

5.1.1.2 The Site Lead Case Manager shall possess the expertise to provide oversight in non-clinical case management, case management planning, analysis and review, patient risk analysis and service support.

5.1.1.3 The Site Lead Case Manager may also be required to perform case management tasks.

5.1.2 Case Management.

5.1.2.1 Track the medical status of Service Members (SM).

NON-CLINICAL CASE MANAGEMENT SERVICES

5.1.2.2 The Non-Clinical Case Management Services requires the use of the following DOD and Army web-based electronic data systems, Medical Operational Data System (MODS) and Medical Electronic Data for Care History and Readiness Tracking (MEDCHART).

5.1.2.3 MODS includes the following applications:

1. Armed Forces Health Longitudinal Technology Application (AHLTA);

2. Electronic Profile (e-Profile);

3. Medical Data Protection System (MEDPROS);

4. Medical Health Assessments (MHA);

5. MEDPROS Web Data Entry (MWDE);

5.1.2.4 MEDCHART includes the following applications:

1. Automated Voucher System (AVS);

2. Dental Classification Module (DENCLASS);

3. Electronic Case Management (eCase); and

4. Health Readiness Record (HRR)

5.1.2.5 - Data Entry into the following systems: Medical Operational Data System (MODS), MEDPROS, MWDE

5.1.2.6 - Scanning and filing of digital and physical Soldier Treatment Records

5.1.2.7 - Initiate and document physical profile and follow on treatment requirements

5.1.2.8 - Log contact (email, telephone call, or personal interview) and updates with SM/cases in MedLog and other medical tracking systems.

5.1.2.9 - Initiate, process and track medical board cases (MEB, PEB, MAR2).

5.1.2.10 - Attend Physical Health Assessment (PHA) events as determined by the needs of the WYARNG and the individual units.

5.1.2.11 - Ensure SM’s referred by a provider are followed by the case management team.

5.1.2.12 - Contact SM and physician/dental offices to obtain medical documentation and information regarding open cases for treatment plan review.

5.1.2.13 - Support SM in becoming Fully Medically Ready (FMR) by tracking medical and dental appointments.

5.1.2.14 - Communicate with unit regarding SM medical appointments to ensure attendance and submission of follow-up documentation.

5.1.2.15 - Request profile exams/evaluations and audiology exams at Physical Health Assessment

(PHA).

5.1.2.16 - Review and track health assessment lab results, contacting the unit and SM to follow-up if abnormalities are found or coordinate if further testing is required.

5.1.2.17 - Document cases in the eCase module of the MEDCHART within one business days of notification of appointment, lab results, or action related to treatment plan.

5.1.2.18 - Follow the regulations and policies applicable to Individual Medical Readiness (IMR) and deployment, to include the AR 40-501, AR 40-502, AR 40-66, AR 40-400, AR 40-58, AR 600-8-4, AR 25-50, WYARNG specific Memorandums of Instruction (MOI), and other regulations and policies as determined by the COR.

5.1.2.19 - Coordinate with SMs who have LOD and non-LOD injuries or illness to ensure that the care is properly managed, minimizing amount of time in non-deployable status.

5.1.2.20 - Maintain SM medical records in accordance with Army Regulation (AR) 40-66, The Privacy Act of 1974 and HIPAA standards and guidelines.

5.1.2.21 - Ensure Soldiers with all temporary and permanent profiles are case managed in the eCase module.

NON-CLINICAL CASE MANAGEMENT SERVICES

5.1.2.22 - Inform provider of the SM’s status and furnish them with the mandatory information and documentation.

5.1.2.23 - Manage SM’s care from the identification of the condition to when the Soldier is either considered medically ready or administratively separated from the military.

5.1.2.24 - Stamp all medical documents with date stamp and action completed after uploading.

5.1.2.25 - Submit case processing, medical documentation, and profile concerns to military or contacted provider.

5.1.2.26 - Meet with the DSS and the COR to review all cases in progress on a monthly basis.

5.1.2.27 - Prepare and submit Detailed Dental Treatment Reports to DSS on a monthly basis.

Report is due the 15th of each month.

5.1.2.28 - Ensure proper maintenance of SM medical records in accordance with HIPAA and the Privacy Act.

5.1.2.29 - Utilize DOD and Army web-based electronic data systems, MODS and MEDCHART, including the applications listed in Section 5.3.2.

5.1.2.30 - Follow regulations and policies applicable to IMR and deployment, including AR 40- 501.

5.1.2.31 - Validate the accuracy of the electronic and hard copy of the SM treatment plan.

5.1.2.32 - Obtain SM’s signature on the release of information form.

5.1.2.33 - Perform Automated Voucher System actions in MODS.

5.1.2.34 - Perform MEDPROS SM data entry and the medical functions in Mobilization Planner Data Viewer (MPDV) within one business day of receipt.

5.1.2.34 - Ensure that each case is reviewed and charted at each of the following occurrences:

5.1.2.34.1 - Upon receipt of documentation;

5.1.2.34.2 - Medical status changes;

5.1.2.34.3 - Communication with civilian medical entities;

5.1.2.34.4 - Contact with the SM; and

5.1.2.34.5 - Every 30 days for 12 months to determine medical readiness.

5.2.2.34.6 - Every note shall include the following SM identifiers:

a. Name;

b. Last 4 of Social Security Number

c. Gender;

d. Synopsis of medical documentation received or reason for note;

e. Any subjective and objective information identified;

f. Status of profiles;

g. MEDPROS status; and

h. Next steps in the plan of care.

5.1.2.35 - Monitor MEDPROS to ensure all scheduled services are completed/updated and current medical status is reflected.

5.1.2.36 - Retrieve SM records in preparation of medical board packets, pre-deployment medical readiness events, and case reviews.

5.1.2.37 - Track medical and dental appointments, contact unit and SM to remind of appointments, and confirm attendance.

5.1.2.38 - Scrub MEDPROS data before SRPs for early identification of non-deployable Soldiers.

NON-CLINICAL CASE MANAGEMENT SERVICES

5.1.2.39 - Ensure Contractor correspondence is in accordance with AR 25-50 and Army National Guard Memo 25-52 in regard to format, accuracy, and content.

5.1.2.40 - Ensure proper disposition of medical treatment records based upon SM transfer across military branches of service, transfers across component, interstate transfer within the National Guard, retirement, or discharge from service.

5.1.2.41 - Provide copies of supporting transfer documents to the COR no later than seven calendar days after the end of the month.

5.2. Contractor Manpower Reporting Application (CMRA):

5.2.1. The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the National Guard Bureau via a secure data collection site.

5.2.2. The contractor shall completely fill in all required data fields using the following web address: http://www.ecmra.mil/. Reporting inputs shall be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2020. Contractors may direct questions to the help desk at http://www.ecmra.mil.

6. Applicable Publications: Publications applicable to this PWS are listed below. All Army publications can be found at http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx.

Department of Defense Publications are at http://www.dtic.mil/whs/directives/corres/dir.html.

Publication (Chapter/Page) Date of Publication Mandatory or Advisory

DoDD 5400.11, Department of Defense Privacy Program

10/29/2014 Mandatory

DoD 8570.01-M, Information Assurance Workforce Improvement Program

12/19/2005 (Change 4:

11/10/2015)

Advisory

Army Directive 2014-05, Policy and Implementation Procedures for Common Access Card Credentialing and Installation Access for Uncleared Contractors

03/07/2014 Mandatory

AR 25-2, Cyber Security 04/04/2019 Mandatory AR 25-50, Preparing and Managing Correspondence

05/17/2013 Mandatory

AR 40-66, Medical Record Administration and Health Care Documentation

06/17/2008 Mandatory

AR 40-501,Standards of Medical Fitness 06/27/2019 Mandatory

NON-CLINICAL CASE MANAGEMENT SERVICES

AR 40-502, Medical Readiness 06/27/2019 Mandatory

AR 135-175, Separation of Officers 11/29/2017 Advisory

AR 135-178, Enlisted Administrative Separations

11/07/2017 Advisory

AR 135-381, Incapacitation of Reserve Component Soldiers

12/27/2006 Advisory

AR 190-13, The Army Physical Security Program

06/27/2019 Advisory

AR 530-1, Operations Security 09/26/2014 Mandatory AR 600-110, Identification, Surveillance, and Administration of Personnel Infected with HumanImmunodeficiency Virus

04/22/2014 Mandatory

AR 635-40, Disability Evaluation for Retention, Retirement or Separation

01/19/2017 Mandatory

DA PAM 611-21, Military Occupational Classification and Structure

07/19/2018 Mandatory

6.1 Applicable Forms: Forms applicable to the PWS are listed below:

Form Date Website

DD 1172-2, Application for Identification Card/DEERS Enrollment

03/01/2017 http://www.dtic.mil/whs/directives/forms/index.htm

I-9, Employment Eligibility Verification

11/14/16 https://www.uscis.gov/sites/default/files/files/form/i- 9.pdf

DD 441, Department of Defense Security Agreement

01/01/2017 http://www.dtic.mil/whs/directives/forms/dd/ddforms000 1-0499.htm

DD 250, Material Inspection and Receiving Report

01/01/2000 http://dtic.mil/whs/directives/forms/dd/ddforms0001- 0499.htm

PSIP request Form March

Internal Process Document

Request for Background Investigation

06/02/2017 Internal Process Document

NON-CLINICAL CASE MANAGEMENT SERVICES

TECHNICAL EXHIBIT 1

PERFORMANCE REQUIREMENTS SUMMARY

Non-Clinical Case Management Services

PO # PWS PARA PERFORMANCE

OBJECTIVE

PERFORMANCE THRESHOLD

SURVEILLANCE

METHOD &

FREQUENCY

PO 1 Data Entry into the following systems:

Medical Operational Data System

(MODS),

MEDPROS, MWDE

and any other medical data entry sites

Data Entry completed within Performance Threshold

E: completed within 2 working days from receipt

Periodic Inspection

VG: completed within 3-5 working days from receipt

S: completed within 6-10 working days from receipt

M: completed within 11-15 working days from receipt

U: completed 16 or more working days from receipt

PO2 Scanning and filing of digital and physical Soldier Treatment Records

Deliverables prepared by contractor accurately address all aspects of the requirement

E: Completed within 5 working days from receipt with 0 errors.

Periodic Inspection

VG: Completed within 5 working days from receipt with less than 2 errors

S: Completed within 6-10 working days from receipt with less than 3 errors

M: Completed within 6-10 working days from receipt with more than 3 errors

U: Completed over 11 working days from receipt and/or with more than 3 errors.

PO3 Initiate and document physical profile and follow on treatment requirements

Deliverables prepared by contractor accurately address all aspects of the requirement

E: Initiate within 1 working days, follow-up within 15 days or less.

Periodic Inspection, Customer Feedback

VG: Initiate within 2 working days, follow-up within 15 days

S: Initiate within 2 working days, follow-up within 30 days

NON-CLINICAL CASE MANAGEMENT SERVICES

PO # PWS PARA

PERFORMANCE

OBJECTIVE PERFORMANCE THRESHOLD

SURVEILLANCE

METHOD &

FREQUENCY

M: Initiate within 3 working days, follow-up/track within 45 days

U: Initiate within 4-5 working days, follow-up/track 45 days or more

PO4 Log contact (email, telephone call, or personal interview) and updates with SM/cases in MedLog and other medical tracking systems (email, telephone call, or personal interview).

Deliverables completed within Performance Threshold

E: Log contact/updates same day of contact/update

Periodic Inspections;

100% inspection

S: Log contact/updates within 1 working day of contact/update.

M: Log contact/updates within 2 working day of contact/update.

U: Log contact/updates 3 working days or more from contact/update

PO5 Initiate, process and track medical board cases (MEB, PEB, MAR2).

Deliverables prepared by contractor accurately address all aspects of the requirement

E: Initiate board process within 2 working days, track and update weekly (leader reports, Medlog, eCase) until complete.

Periodic Inspection

VG: Initiate board process within 3-4 working days, track and update weekly (leader reports, Medlog, eCase) until complete.

S: Initiate board process within 5 working days, track and update weekly (leader reports, Medlog, eCase) until complete.

M: Initiate board process greater than 5 working days, track and update bi-weekly (leader reports, Medlog, eCase) until complete.

U: Initiate board process greater than 10 working days, track and update bi-weekly (leader reports, Medlog, eCase) until complete.

NON-CLINICAL CASE MANAGEMENT SERVICES

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.5.3. Back ground

investigation documentation for Common Access

Card

Earliest possible date (Job cannot be performed without CAC)

1 Electronic or hard copy submission

COR

1.6.1.8. HIPAA

Training

Upon contract award and annually thereafter

1 Electronic Submission of Training Certificate

COR

1.6.1.9. AT Level 1

Awareness Training Certificates

30 calendar days after contract award

1 Electronic Submission of

Training Certificate

COR

1.6.1.11.

Information Awareness

15 calendar days after contract award and annually thereafter

1 Electronic Submission of

Training Certificate

COR

1.6.1.12. iWatch Training Certificates

15 calendar days after contract award

1 Electronic Submission of

Training Certificate

COR

1.7. OPSEC

Training Certificates

15 calendar days after contract award

1 Electronic Submission of

Training Certificate

COR

1.7.1. OPSEC Level

II Certification for OPSEC Coordinator

15 calendar days after contract award

1 Electronic Submission of

Training Certificate

COR

1.11. Contract

Manager

Receipt of Letter 10 days after Contract Award

1 Electronic or hard copy submission

COR

NON-CLINICAL CASE MANAGEMENT SERVICES

TECHNICAL EXHIBIT 3

Estimated Workload Data

This information is provided for historical background only. It is not a guarantee of workload quantities.

ITEM NAME ANNUAL ESTIMATED QUANTITY

1 Physical Health Assessments Events Completed

*Note: PHA events average 225 personnel per event with as many as 380 and as little 30

13 (2015)

14 (2016)

13 (2017)

9 (2018)

2 Number of Wyoming Army National Guard Personnel

1641 (2015)

1500 (2016)

1526 (2017)

1505 (2018)

3 Number of Referrals per year 161 (2015)

216 (2016)

366 (2017)

342 (2018)

4 Number of Soldier Treatment Records (STR) for digital and hard copy record keeping

(each STR has up to 30 years of medical documentation for each Soldier)

3400 (2015)

3540 (2016)

3260 (2017)

3500 (2018)