(Attachment 1) Case Management PWS.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

Case Management Services

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Case Management Services, as defined in this

PWS.

1.2 Background: In 2009, a Medical Management Guide was issued by the Office of the Assistant Secretary of Defense for Health Affairs (ASD [HA]) and TMA, Office of the Chief Medical Officer (OCMO), Population Health and Medical Management Division (PHMMD). The Guide covers the components of a Medical Management (MM) program, including applicable principles, implementation concepts, processes, and tools/databases for Utilization Management (UM), Case Management (CM), and Disease Management (DM). It complements the 2001 DoD Population Health Improvement Plan and Guide published by TMA and the Government Printing Office http://www.tricare.mil/ocmo/download/mhs_phi_guide.pdf.

Under legislative mandates, the ASD (HA) submitted an annual report to Congress regarding healthcare delivery for Military Health System (MHS) beneficiaries. The 2009 report documented the MHS goal to providing high-quality care, improving performance through clinical and process outcomes, and increasing patients’ confidence in the care they receive. The Guide describes crucial components of Medical Management within the MHS, including the link between MM and population health and the dynamics between Utilization Management, Case Management and Disease Management in helping reduce unnecessary or inappropriate services and/or duplication of services. In the military setting, Case Management targets Active-Duty Service Members and beneficiaries with complex, multi-system healthcare needs who require care coordination or case management services. Originally, Case Management almost exclusively targeted in-patients with catastrophic illnesses or injuries. However, a number of developments have served to change that strategy; notably:

- The emergence of the National Committee for Quality Assurance (NCQA):

http://www.ncqa.orgorg/.

- The development of accreditation standards by the Utilization Review Accreditation Commission (URAC): http://www.urac.org.

While Case Management continues to focus on catastrophic illness or injury, Case Management practices are also intensely directed at addressing chronic conditions that are more prevalent in the general patient population. Case managers can affect patient http://www.tricare.mil/ocmo/download/mhs_phi_guide.pdf http://www.ncqa.orgorg/ http://www.urac.org/ outcomes through proactive interventions across multiple healthcare settings.

Additionally, case managers are expected to engage community resources and facilitate ongoing and consistent patient education.

The MHS has three primary goals for Case Management:

- Improve the care, management, and transition of recovering Service members.

- Broaden the application of CM to include those with complex and at-risk needs before the Soldier requires complex care.

- Evaluate the impact of case management on the quality of military health care.

1.3 Period of Performance (PoP): The Period of Performance shall be one base year of 12 months.

1.4 General Information:

1.4.1 Place and Performance of Services:

The contractor shall provide services between the hours of 7:00 a.m. to 4:30 p.m. on Monday through Friday, except on 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. Performance shall be in Salem, Oregon and Roseburg, Oregon. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons.

When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential. Telework is authorized. Travel to Medical Readiness will not be needed during FY24. Travel to and from the primary worksite will not be reimbursed by the government.

1.4.1.1 Telework: The Government will permit the contractor to telework in support of this requirement. In furtherance of Continuity of Operations Planning (COOP), a telework program may be enacted to ensure that the Government's mission-critical operations stay operational during times of national emergency or incidents of national significance. Telework shall be at no additional cost to the Government.

1.4.1.2 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.1.3 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 always carry proper identification 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.

1.4.2 Recognized Holidays: The following are recognized United States (US) holidays.

The contractor shall not perform services on these days:

1.4.2.1 New Year’s Day: January 1st

1.4.2.2 Martin Luther King, Jr.’s Birthday

1.4.2.3 President’s Day

1.4.2.4 Memorial Day

1.4.2.5 Juneteenth

1.4.2.6 Independence Day: July 4th

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.9 Veteran’s Day: November 11th

1.4.2.10Thanksgiving Day

1.4.2.11 Christmas Day: December 25th

1.4.3 Quality Control (QC): The contractor shall develop and maintain an effective QC 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 how 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.

1.4.4 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).

1.4.5 Installation Access and 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.

1.4.5.1 For contractors requiring Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential. Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated Tier 1 or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled Tier 1 investigation at the Office of Personnel Management.

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).

1.4.5.1.1 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) form at Attachment 4 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.

1.4.5.1.2 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. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA). The TASS TA for this requirement will be: TBD

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.

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

a. 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/).

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

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

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

1.4.5.1.3 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 https://www.dmdc.osd.mil/tass/ http://www.dmdc.osd.mil/rsl/) 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.

1.4.5.1.4 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 COR or KO.

1.4.5.1.5 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. Failure to comply with these requirements may result in withholding of final payment.

1.4.5.1.6 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 COR or KO.

1.4.5.1.7 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. 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.

1.4.5.2 Awareness Training (AT) Level 1: All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete AT Level 1 training 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 by each employee or subcontractor personnel. AT Level 1 awareness training is available at the following website: https://jko.jten.mil/courses/atl1/launch.html.

1.4.5.3 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program (training standards provided by the requiring activity Antiterrorism Officer (ATO)). This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR, within 15 calendar days after completion of training.

1.4.5.4 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to 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 that any time contractor personnel 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.

1.4.5.5 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 Army Enterprise Infostructure (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:

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

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

1.4.5.8 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.

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

1.4.5.10Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.

1.4.5.11 Army Training Certification Tracking System (ATCTS): All contractor employees with access to a Government information system shall be registered in 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://iatraining.us.army.mil/).

1.4.5.12 Information Assurance (IA) Training. All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before https://informationassurance.us.army.mil/ issuance of network access and annually thereafter.

1.4.5.13 Protection of Personally Identifiable Information (PII). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (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 whose PII has been compromised.

1.4.5.14 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 contractor employee to the COR within 15 calendar days after completion of training. Level 1 OPSEC training is available at https://securityawareness.usalearning.gov/opsec/index.htm.

1.4.5.15 OPSEC SOP/Plan. The contractor shall develop an OPSEC Standard Operating Procedure (SOP)/Plan and provide it to the COR within 90 calendar days of contract award, to be reviewed and approved by the responsible Government OPSEC officer, per AR 530-1, Operations Security. This SOP/Plan shall include a process to identify the government's critical information, why it needs to be protected, where it is located, who is responsible for it, and how to protect it. The contractor shall implement OPSEC measures as required by the Government. In addition, the contractor shall identify an individual who will be an OPSEC Coordinator. The contractor shall ensure this individual becomes OPSEC Level II certified within 90 days of appointment as OPSEC coordinator in accordance with AR 530-1. Contractor shall provide a copy of the certification to the COR NLT 15 days after completion.

1.4.5.16 Threat Awareness and Reporting Program (TARP). Per AR 381-12, Threat Awareness and Reporting Program (TARP), contractor employees with security clearances must receive annual TARP training by a counterintelligence (CI) agent or other trainer as specified in Chapter 2 Threat Awareness and Education, Section II, paragraph 2-4b. The contractor shall identify annual TARP training, personnel trained and date of training annually.

1.4.6 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.

1.4.6.1 Key Control. NOTE: All references to keys include key cards. The contractor shall establish and implement methods of ensuring that no keys/key cards issued by the https://securityawareness.usalearning.gov/opsec/index.htm Fellwock, Joshua D CIV NG ORARNG (USA) If this is required, the AT-OPSEC form must have block 6 checked by the provost marshal.

Government are lost or misplaced or are used by unauthorized persons. No keys issued by the Government shall be duplicated. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The contractor shall include procedures covering key control in the QCP.

1.4.6.1.1 The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the COR.

1.4.6.1.2 In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon direction by the KO, re-key or replace the affected lock or locks;

however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the Government replaces or re-keys the locks, the Government will deduct the total cost of lock replacement or re-keying from the monthly payment due the contractor. In the event a master key is lost or duplicated, the Government will replace all locks and keys for that system and will deduct the total cost from the monthly payment due the contractor.

1.4.6.1.3 The contactor shall prohibit the use of the Government issued keys/key cards by any persons other than the contractor’s employees. The contractor shall prohibit the opening of locked areas by contractor employees to permit entrance of persons other than contactor employees engaged in the performance of services in those areas, or personnel authorized entrance by the KO.

1.4.7 Special Qualifications: The Contractor is responsible for ensuring Case Management personnel meet the standards directed by AR 40-68 and are licensed within the state as appropriate. Case Managers must be licensed in accordance with Chapter(s) 4-8 and/or Chapter(s) 7-10.

1.4.7.1 Contractors are required to provide proof of Professional Liability Insurance for all Medical Personnel supporting clinical requirements. Non-clinical personnel may be covered by the Contractor’s General Liability Insurance Policy. All Contractor employees shall read, understand, speak, and write English fluently.

1.4.8 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR Subpart 42.5. The KO, COR, and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will apprise the contractor of how the Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.9 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.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that 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.

1.4.11 The contractor shall retrieve all identification media (including vehicle passes) from its employees who depart employment for any reason. The contractor shall return all identification media (i.e., badges and vehicles passes) to the KO within 14 days of an employee’s departure.

1.4.12 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 any form 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 labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at

FAR 22.17.

1.4.12 Contractor Travel: Contract employees will not be required to travel.

1.4.13 Data Rights: The Government has unlimited rights to all documents/materials produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.4.14 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 that 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. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose 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.

2.0 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, 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 Representative (COR): An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that 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 that does not meet the standard of performance associated with the PWS.

2.1.5 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.6 Key Personnel: Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

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 that 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 ensure that the quality of an end product or service shall meet 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.

2.1.12 WORK HOURS. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.13 WORK WEEK. Monday through Friday, 40 hours per week

2.2 Acronyms:

AEI Army Enterprise Infostructure AFARS Army Federal Acquisition Regulation Supplement AKO Army Knowledge Online AR Army Regulation ASD[HA] Assistant Secretary of Defense for Health Affairs ATCTS Army Training Certification Tracking System AT/OPSEC Antiterrorism/Operational Security AVS Automated Voucher System AUP Acceptable Use Policy AWOL Absent Without Leave BI Background Investigation BBP Best Business Practices CAC Common Access Card CFR Code of Federal Regulations CM Contract Manager COMSEC Communications Security COR Contracting Officer Representative DA Department of the Army DEERS Defense Enrollment Eligibility Reporting System DENCLASS Dental Classification Module DD250 Department of Defense Form 250 (Receiving Report) DFARS Defense Federal Acquisition Regulation Supplement

DM Disease Management DoD Department of Defense DoDI Department of Defense Instruction DoDM Department of Defense Manual DSS Deputy State Surgeon e-QIP Electronic Questionnaires for Investigations Processing FAR Federal Acquisition Regulation FBI Federal Bureau of Investigation FMR Fully Medically Ready FPCON Force Protection Condition FSO Corporate Facility Security Officer GFP/M/E/S Government Furnished Property/Material/Equipment/Services HQDA Headquarters, Department of the Army HRR Health Readiness Record HSPD Homeland Security Presidential Directive HSS Health Services Specialist IA Information Assurance IAT Information Assurance Technical IMR Individual Medical Readiness IS Information System(s) KO Contracting Officer LOD Line of Duty MEB Medical Evaluation Board MEDCHART Medical Charting MEDPROS Medical Data Protection System MHA Mental Health Assessment MHS Military Health System MM Medical Management MND Medically Non-Deployable MRP Medical Readiness Portal MSTATEO Military Medical Support Office MTF Military Treatment Facilities MWDE Medpros Web Data entry NACI National Agency Check with Inquiries NCQA National committee for Quality Assurance NGB National Guard Bureau OCI Organizational Conflict of Interest OCMO Office of the Chief Medical Officer ORARNG Oregon Army National Guard PAD Detachment Patient Administration PEB Physical Evaluation Board PHMMD Population Health and Medical Management Division PII Personally Identifiable Information PIV Personal Identity Verification POC Point of Contact PRS Performance Requirements Summary

PSIP Personnel Security Investigation Portal PWS Performance Work Statement QA Quality Assurance QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program RAPIDS Real-Time Automated Personnel ID System RHRP Reserve Health Readiness Program SITREP Situational Report SPL Soldier Patient Locator SRP Soldier Readiness Program SSN Social Security Number SOP Standard Operation Procedure TA Trusted Agent TARP Threat Awareness and Reporting Program TASS Trusted Associated Sponsorship System TDP TRICARE Dental Program TE Technical Exhibit TMA TRICARE Management Activity UM Utilization Management URAC Utilization Review Accreditation Commission VA Veterans Affairs WTR Warrior Transition Report

3.0 Government Furnished Property, 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: N/A

3.3 Equipment: N/A

3.4 Services: N/A

3.5 Utilities: All utilities in the facility will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.

4.0 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 indicated in Paragraph 1.1.

5.0 Requirements: The contractor shall: Provide all personnel and perform all tasks within the section during performance of the contract.

5.1 RN Case Managers: Contractor shall, at a minimum, provide case managers who are a Registered Nurse (RN) with an active unrestricted license in Oregon and who have graduated from an accredited nursing school (see para 1.4.7 for special qualification requirements).

5.1.1 Case management consists of assessment, planning, implementation, coordination, monitoring and evaluations of the options and services required to meet the ORARNG Soldier’s health and human service needs. The Contractor Case Managers shall be familiar with the regulations and policies that apply to Individual Medical Readiness (IMR) and deployment.

5.1.2 The Contractor Case Managers shall be responsible to know and become familiar with the associated ORARNG web-based electronic data systems via MODS to include:

- Medpros Web Data entry (MWDE)

- Medical Readiness Portal

- Mental Health Assessment (MHA)

- Medical Non-Deployable (MND)

- Dental Classification Module (DENCLASS)

- Health Readiness Record (HRR)

- Medical Data Protection System (MEDPROS)

- Soldier Patient Locator (SPL)

- Line of Duty (LOD)

- Automated Voucher System (AVS)

- Warrior Transition Report (WTR).

5.1.3 Case Manager Duties will include:

5.1.3.1 All cases, regardless of type (medical or dental) or duration, must be documented in the Medical Non-Deployable (MND) Module of the Medical Operational Data System (MODS). Contractor Nurse Case Managers shall have a monthly team meeting with the COR, Deputy State Surgeon (DSS) and Health Services Specialist (HSS) to review all cases in progress. Because this requirement involves multiple working locations, these meetings may be conducted either in person or via telephonic or video conferencing.

5.1.3.2 Documents results of a Bi-weekly case review in the referrals tab of the MND Module. These reviews will be used in the monthly meeting with the DSS.

5.1.3.3 The Contractor Case Manager shall provide a weekly MND Case Report to the DSS. The report shall include number of new referrals initiated, active cases and number of closed cases.

5.1.3.4 Maintain appropriate licensure and credentials that the COR will validate upon hiring.

5.1.3.5 Coordinate with Soldiers to assess and arrange for the treatment of Soldiers with conditions that have or will result in them being Medically/Dentally non-deployable.

Such services include outreach, assisting with appointment scheduling, and going to SRP events, (both for mobilization/deployment and routine readiness).

5.1.3.6 Assist Soldier’s in the Medical Screening program. Assists with appointments and ensures documentation is retrieved from appointments and placed in appropriate electronic record, as well as the Soldier’s hard copy medical record.

5.1.3.7 Track and assist in the guidance of a Soldier’s care from the receipt of the condition to when the Soldier is deployable or the documentation is sent to the Health Services Specialist (HSS) for a Fitness for Duty evaluation where appropriate or to a MEB, PEB or Personnel Board. Will then assist the Soldier to facilitate the expeditious processing through the appropriate medical board.

5.1.3.8 Performs initial interviews with Soldiers regarding a deployment limiting condition within 48 hours of notification of a Soldier with a deployment limiting condition.

Ensures the Soldier understands his/her responsibilities and obtains a release of information form. Provide information to Soldiers about their privacy rights and how their information can be used (have Soldiers sign consent form). The Contractor shall also be responsible for protecting the confidential nature of Soldiers’ files and medical issues.

5.1.3.9 Conduct follow-up interviews during which the Contractor Case Manager shall coordinate treatment plans and all referrals when the care is being resourced by the government (e.g., Dental Treatment using Reserve Health Readiness Program (RHRP) or local contracts etc.).

5.1.3.10 Maintain Soldier medical records in accordance with Army Regulation (AR) 40-66.

5.1.3.11 Coordinate care received by TRICARE and by the Military Medical Support Office (MSTATEO) to obtain prior authorization for treatment during the Early TRICARE period, up to 90 days prior to Mobilization (the Contractor Nurse Case Managers do not establish eligibility, this is a personnel function).

5.1.3.12 Provide the State Medical Detachment Patient Administration (PAD) Officer or delegate with all relevant medical/dental documentation.

5.1.3.13 Operates a Government furnished computer to input, store, retrieve and manipulate data for various reports as required by this PWS. Uses various software programs to maintain database files and prepare reports. Must be proficient in Microsoft Word, Excel, PowerPoint and Outlook.

5.1.3.14 Contractor Case Managers shall inform ORARNG provider(s) responsible to evaluate follow up of the Soldiers’ status with mandatory information/documentation.

5.1.3.15 Coordinate Soldiers’ health care including consults for those initially using Military Treatment Facilities (MTF), VA, TRICARE network provider, and non-network providers.

5.1.3.16 Present a list of available local resources within the state to ensure Soldiers have alternative options available to receive medical or dental care if not eligible for military health benefits.

5.1.3.17 Educate Soldiers on resources available to improve medical and dental readiness (TRICARE Dental Program (TDP), local community resources, ARNG sponsored programs, e.g., Decade of Health, Hooah4Health.com, State Medical and Dental programs, etc.).

5.1.3.18 The Contractor Case Manager shall assist in preparing Line of Duty (LOD) paperwork for units for which they are responsible.

5.1.3.19 The Contractor Case Manager shall review for accuracy MEDPROS data before SRPs to identify non-deployable Soldiers.

5.1.3.20 The Contractor Case Manager shall enter Individual Vouchers for identified Soldiers into the Automated Voucher System (AVS) in furtherance of a Soldier’s care plan.

5.1.3.21 The Contractor Case Manager will prepare and submit, once approved by the DSS, the weekly Situational Report (SITREP) report for assigned office.

5.1.3.22 The Contractor Case Manager will assist in resolving scheduling conflicts for Soldiers needing Medical or Dental care.

5.1.3.23 The Contractor Case Manager will handle all contacts and work closely with other offices on related medical issues.

5.1.3.24 The Contractor Case Managers shall have at least 12 months experience in the medical or health care field within the past 36 months.

5.2 Non-Clinical Care Coordinator: Will have at a minimum a high school diploma or GED. Care coordinators will manage the care and associated documentation of each assigned Soldier in accordance with the individualized treatment plan. The non-clinical care coordinator personnel will be experienced in all aspects and qualified in their respective functional areas. Contactor personnel shall not perform inherently governmental functions (i.e., representation of government, decision authority, etc.).

5.2.1 Non-Clinical Care Coordinator duties will include:

5.2.1.1 Tracking medical status of ALL assigned Soldiers.

5.2.1.2 Medical charting in eCase (MEDCHART).

5.2.1.3 Requesting profile exams/evaluations and audiology exams at physical exam center.

5.2.1.4 Coordinating Soldier treatment plans with appropriate medical facilities.

5.2.1.5 Maintaining automated referrals indicated in MEDCHART.

5.2.1.6 Submitting case processing, medical documentation, and profile concerns to military/contacted provider.

5.2.1.7 Attending PHA events as determined by the needs of the state and the individual units.

5.2.1.8 Ensure Soldiers referred by a provider are followed by the case management team.

5.2.1.9 Managing Soldier’s care from the identification of the condition to when the Soldier is either: Considered medically ready or is administratively separated from the military.

5.2.1.10 Following the regulations and policies applicable to Individual Medical Readiness (IMR) and deployment, to include the AR 40-501 and other applicable guidance.

5.2.1.11 Ensuring all medical documentation received from the Soldier and/or their medical team is received and placed in appropriated electronic record, as well as the Soldier’s hard copy record.

5.2.1.12 Maintaining Soldier medical records in accordance with Army Regulation

(AR) 40-66.

5.2.1.13 Providing Records Custodian or delegate with all relevant medical/dental documentation.

5.2.1.14 Obtaining release of information documents from Soldier.

5.2.1.15 Educating Soldiers on resources available to improve medical and dental readiness.

5.2.1.16 Maintaining Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines.

5.2.1.17 Reviewing and tracking health assessment (PHA, SRP) lab results contact SM and educate on lifestyle modifications.

5.2.1.18 Uploading, stamping and indexing medical documents of case managed Soldiers into Health Readiness Record (HRR).

5.2.1.19 MODS entry of immunizations, designation of pregnancy, eye exams, medical warning tags.

5.2.1.20 Providing all medical documents received for case management to Records Custodian to be filed using a document evidencing transfer of custody from the Contractor to the government. Copy of each supporting transfer document shall be provided to the COR at the end of each month, submitted no later than 7 calendar days through the beginning of the next month.

5.2.1.21 Tracking medical appointments by communication with unit to ensure Soldier attendance and submission of follow up documentation.

5.2.1.22 Logging in eCase any contact with SM (email, voice call, or personal interview). Contractor will ensure all administrative charting in eCase is completed.

5.2.1.23 Communicating with delegated government personnel to track compliance versus noncompliance.

5.2.1.24 Running and monitoring MEDPROS reports Post PHA/SRP events to ensure all scheduled services are completed/updated and current medical status is reflected.

5.2.1.25 Reporting Medical Readiness to the Commander or his/her designated representative.

5.2.1.26 Ensuring Soldiers with T3, T4, P3 or P4 profiles are case managed in the eCase module.

5.3 Contract Manager (CM):

5.3.1 The CM will be located in the continental United States in order to provide responsive program integration and support to onsite contractor staff.

5.3.2 The CM will track all required employee training, licensure and be prepared to provide certificates to the COR during any during any quality inspections.

5.3.3 The CM will provide a monthly status report of all case load closed out and currently being worked that month. The report will identify any issues, customer complaints, or training renewals that happened during the reported period.

6.0 Applicable Publications: Publications applicable to this PWS are listed below:

Publication (Chapter/Page)

Date of Publication

Mandatory Website

DoDM 1000.13-M-V1 DoD Identification (ID) Cards (Enclosure 2, paragraph 3.b)

01/23/2014 Y http://www.esd.whs.mil/Directives/issuanc es/dodm/

Federal Information Processing Standards (FIPS) Publication

201-2 Personal Identity Verification (PIV) of Federal Employees and Contractors (paragraph 9)

August

Y http://nvlpubs.nist.gov/nistpubs/FIPS/NIST .FIPS.201-2.pdf

DoDM 5200.2 Regulation

5200.02 Procedures for the

DoD Personnel Security Program (PSP)

04/03/2017 Y http://www.dtic.mil/whs/directives/corres/p ub1.html

Army Directive 2014-05 Policy and Implementation Procedures for Common

Access Card Credentialing and Installation Access for Uncleared Contractors

03/07/2014 Y http://www.apd.army.mil/ProductMaps/Pub Form/ArmyDir.aspx

AR 190-13

The Army Physical Security

Program

02/25/2011 Y http://www.apd.army.mil/ProductMaps/Pub Form/AR.aspx

Homeland Security Presidential Directive (HSPD)-12 Policy for a Common

Identification Standard for

08/27/2004 Y https://www.dhs.gov/homeland-security-presidential-directive-12 http://www.esd.whs.mil/Directives/issuanc http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf http://www.dtic.mil/whs/directives/corres/pub1.html http://www.dtic.mil/whs/directives/corres/pub1.html http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx http://www.apd.army.mil/ProductMaps/PubForm/AR.aspx http://www.apd.army.mil/ProductMaps/PubForm/AR.aspx https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.dhs.gov/homeland-security-presidential-directive-12

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