Attachment B - Statement of Work.pdf

National Maternal Mental Health Hotline

Statement of Work (SOW)

July 14, 2023

I. Project Title

National Maternal Mental Health Hotline

II. Background

The United States suffers from one of the highest maternal death rates, with suicide and drug overdose being the leading causes of death during the first year postpartum.1 Depression during and after pregnancy—up to 12 months after delivery—is one of the most common medical complications of pregnancy and childbirth.

Approximately one in eight women experience symptoms of depression after pregnancy,2 but maternal mental health conditions, like anxiety, depression, or substance use, can occur during, or after pregnancy. To help address these issues, the Maternal Mental Health Hotline was first funded under the Consolidated Appropriations Act, 2021 (P.L. 116-260), which indicated that HRSA should establish and maintain a maternal mental health hotline to be staffed by qualified counselors, 24 hours a day, and support outreach to raise awareness about maternal mental health issues and the hotline.

The National Maternal Mental Health Hotline, launched by HRSA on Mother’s Day, May 8, 2022, provides free, confidential, 24/7 emotional support, resources and referrals from professional counselors to pregnant and postpartum individuals facing mental health challenges and their loved ones. Counselors offer support in English and Spanish via phone and text, and interpreter services are available in about 60 additional languages.

III. Purpose

The purpose of this requirement is to provide a national, confidential maternal mental health hotline (“hotline”) to be staffed by qualified counselors, 24 hours a day, 7 days a week, 365 days a year. Counselors shall provide immediate psychosocial support, evidence-based information, brief intervention, resources and referrals via telephone, text, and live web chat, to pregnant or postpartum persons at risk of, or affected by, maternal mental health and substance use disorders, and their families or household members (“help seekers”).

There are three key target audiences for the hotline:

1) Diverse pregnant and postpartum people and new parents.

2) Family, household members and other loved ones (e.g., fathers, partners, grandmothers, other family

1 Trost SL, Beauregard J, Njie F, et al. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017-2019. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2022.

2 Bauman BL, Ko JY, Cox S, et al. Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018. MMWR Morb Mortal Wkly Rep 2020; 69:575–581. DOI: http://dx.doi.org/10.15585/mmwr.mm6919a2 https://mchb.hrsa.gov/national-maternal-mental-health-hotline http://dx.doi.org/10.15585/mmwr.mm6919a2 members and friends who influence them).

3) Providers of health care, early childhood, and social and human services who are frequent touchpoints for the target population and can refer them to the hotline.

Specifically, target audiences include:

• End-users of the hotline service (i.e., help-seekers): This shall include diverse pregnant and postpartum individuals who are Black, White, Indigenous, Hispanic, Asian American, Pacific Islanders, Spanish-speaking individuals, individuals with disabilities, members of the LGBTQ+ community, those in the military/veterans, and underserved populations, at a minimum.

• Family, household members, and other loved ones and support persons of pregnant and postpartum individuals, who may also be end-users of the hotline service (help-seekers).

• Health and social and human services providers who interact frequently with the target population. This includes primary care provider networks, birthing center and maternity care hospital networks, community health centers and tribal clinics, childbirth educators, birth and postpartum doulas, lactation consultants, professional health care and mental health care provider associations, various maternal and child health state and national-level organizations, and other federally funded programs serving pregnant people and new parents, especially in rural areas. The hotline shall be promoted via partners’ listservs, newsletters, and some social media channels. Federally funded programs serving this population shall include but are not limited to:

o HRSA’s Healthy Start program, the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, the Title V Maternal and Child Health Services Block Grant, Community Health Centers, and Ryan White HIV/AIDs programs; Administration for Children and Families programs such as Early Head Start, Head Start, Tribal MIECHV, and Temporary Assistance for Needy Families; Indian Health Services’ Maternal and Child Health program; Centers for Disease Control and Prevention Division of Reproductive Health initiatives; the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); relevant programs in the Department of Veterans Affairs, Defense Health Agency, Department of Transportation, and the Housing and Urban Development’s Continuum of Care program.

IV. Period of Performance/Place of Performance

The period of performance will be for one (1) twelve 12-month base period and one (1) 7-month option period.

National Maternal Mental Health Hotline shall be performed at the Contractor’s site(s). The requirements of the Statement of Work can be performed at multiple Contractor sites. The Government reserves the right to require the Contractor to attend meetings/perform the tasks of the SOW at 5600 Fishers Lane, Rockville, Maryland 20857. Notice to attend meetings or perform work at the Government site will be provided by the COR in coordination with the CO.

Task 1. Host Kickoff Meeting

The Contractor shall:

1.1 Meet with the Contracting Officer Representative (COR) and other staff identified by the COR for an in person or virtual kickoff meeting within fifteen (15) business days from the Effective Date of the Contract (EDOC). This meeting shall be to review the Statement of Work (SOW), discuss the deliverables and the schedule/timeline, outline reporting procedures, obtain relevant background information, and identify any items in the SOW that require further clarification. Present the strategic marketing plan and brand strategy. FedRAMP Virtual Meeting solutions (Microsoft Teams or Zoom) or other HRSA approved platform shall be used.

1.2 Electronically submit a draft agenda and supporting documents using a Microsoft Office format three business (3) days prior to the kickoff meeting. Electronically submit a final agenda and supporting documents that incorporates COR feedback one (1) day prior to the kickoff meeting.

1.3 Electronically submit the kickoff meeting minutes using Microsoft Word to the COR, seven business (7) days after the kickoff meeting.

Task 2. Host Project Management Meetings

The Contractor shall:

2.1 Convene bi-weekly (every 2 weeks) conference calls, or ad-hoc as needed, with the COR and other staff identified by the COR, beginning the week after the kickoff meeting. Develop an agenda for the conference calls and email the agenda to the COR, one (1) business day prior to the bi-weekly (every 2 weeks) conference call. The purpose of the calls is to address the following items. These shall be rotating agenda items.

• Project Management, Administration, Personnel, Financial Management

• Hotline Operations, Quality Management, Hotline workforce

• Status chart, with dates of delivery and dates for HRSA review and clearance, on current tasks and deliverables

• Resource and Referral Directory and Functions

• Data, Monitoring and Reporting

• Partnerships and Communications

• Telecommunications, Technology, and IT Security

• Challenges/problems encountered or expected

• Review of key performance indicators and strategies to meet established targets

• Planned tasks, upcoming meetings, and deliverables, and

• Any other issues requiring clarification or discussion.

2.2 Conduct regular meetings and collaborate with other designated entities that have been contracted to provide services to support or enhance hotline operations in coordination the COR, and collaborate, as needed, to provide input on their deliverables. These services may include, but are not limited to marketing, communications, advertising, etc.

2.3 Submit to the COR, two (2) business days after the meetings, brief and concise meeting minutes listing agreements reached and any action items (2 pages or less).

Task 3. Hotline Telecommunications Service

The Contractor shall:

3.1 Maintain, strengthen, and expand as needed, the National Maternal Mental Health Hotline. The Contractor shall provide the capability for help seekers to contact the hotline via text (SMS, short message service) and live web chat networks using a system that is integrated with the HRSA-owned dedicated toll-free telephone number. The Contractor shall ensure continuous operations of telephone calls, texts, and web chat networks, which must be accessible from all 50 States, U.S. territories and the District of Columbia. Provide access to help seekers who are deaf or hearing impaired. HRSA will only provide the toll-free service number that will be pointed to the Contractor-owned or subscribed telecommunication system/service.

3.2 Provide the necessary infrastructure services and capacity to operate and maintain the telephone, text (SMS, short message service), and web chat hotline and all necessary operations 24 hours a day, 7 days a week, 365 days a year. This includes providing the following services:

3.2.1 The hub from which the telecommunications and computer technology platforms and workforce management/scheduling software systems are, or will be, employed to establish and support the hotline operations. This includes all specific systems and networks to support overall project administration, hotline management functions and operations:

workforce management; quality management; resource and referral directory and functions; technology management; monitoring, data reporting and communications; and financial management.

3.2.2 Use of commercial off-the shelf (COTS) contact management software, digital services3, and industry best practices to route and respond to calls and texts in real-time; web chat to be available with an effective date that shall be based on HRSA policy and procedures. All use of COTS contact management software and digital services shall be subject to the SOW

3 The term ‘digital services’ means services, resources, information, support, or referrals provided through electronic communications platforms and media, which may include mobile phone technology, video technology, computer technology (including use of the internet), and any other emerging communications technologies that are appropriate for the purposes of providing services, resources, information, support, or referrals for the benefit of pregnant or postpartum persons experiencing symptoms of perinatal mental health conditions and their loved ones (“help seekers”).

Appendices and approved by HRSA’s Office of Information Technology (OIT) in coordination with the COR.

3.2.3 Access to 24/7 technical support for all hotline system vendors.

3.2.4 The capability for counselors to provide immediate warm transfers to an appropriate crisis line, for a help seeker in crisis, such as someone who is suicidal, or at risk for or experiencing intimate partner violence. The Contractor shall secure formal arrangements (e.g., letters of intent, memoranda of agreement or understanding), and include in the proposal, for bi-directional warm transfers with national crisis lines including the 988 Suicide & Crisis Lifeline, Veteran’s Crisis Line, the Disaster Distress Hotline, and the National Domestic Violence Hotline. Any other national crisis line not included in this section must be approved by the COR before the Contractor shall implement warm transfers to the unlisted national crisis lines.

3.2.5 The capability for counselors to contact 911 in the help-seeker’s local area (based on their provided zip code) if, for example, the individual is in imminent danger of harm to self, others, or has overdosed.

3.2.6 Maintain a 24/7 web chat network utilizing appropriate and up-to date technological systems and services to maximize the hotline’s ability to respond to chat demands including chat technological platforms and portals. Ensure that chats are properly routed to appropriate counselors. Ensure that live web chat is optimized for mobile devices.

3.2.7 Meet HRSA Office of Information Technology requirements described in:

• Appendix A: Section 508 Compliance

• Appendix B: HHS FedRAMP Privacy and Security Requirements

• Appendix C: Protection of Information in a Cloud Environment

• Appendix D: Security Assessment and Authorization (SA&A) Process

• Appendix E: Reporting and Continuous Monitoring

• Appendix F: Configuration Baseline

• Appendix G: Incident Reporting

• Appendix H: Media Transport

• Appendix I: Boundary Protection: Trusted Internet Connections (TIC)

3.3 Establish the organizational capacity to handle a nationwide demand for services, to provide high-quality responses to callers, texters, and web chatters, and to operate within industry call center service level agreements and IT uptime requirements.

3.3.1 In particular, the Contractor shall have the capacity to respond to the anticipated demand (estimated to be an average of 2,000 to 2,500 contacts per month or about 24,000 to 30,000 contacts per year); and respond to surges in demand for services, e.g., in response to national media coverage (e.g., May is Mental Health Month, tragic perinatal loss of famous person), public service announcement, or traumatic events.

3.3.2 Service level requirements are below:

Metric Target Definition Standard for Measure

Calls, Texts, and Chats Answered

Greater than 90%

Total percent of contacts answered

Contacts answered/all contacts (as a total and by mode of contact).

Call, Text, and Chat Speed of Answer

90% of contacts answered in 30 seconds.

Measures the efficiency of the service to answer incoming contacts.

Contacts answered within target/all calls answered (as a total and by mode of contact).

Call, Text, and Chat Average Speed of Answer

Within 30 seconds.

Measure the speed of contacts answered out of IVR queue

Total Waiting Time for Answered Contacts / Total Number of Answered Contacts (as a total and by mode of contact).

Abandonment Rate

Less than 10% Measures contacts disconnected after being routed and before being answered by a counselor.

Number of contacts that disconnect prior to being engaged by a counselor (as a total and by mode of contact).

System Uptime >99.5% system uptime

Measures full system functionality from a customer perspective and not simply hardware availability.

Number of hours system was functioning / Total hours

3.4 Contact the appropriate carrier Account Representative and the COR via telephone immediately and advise of the mitigation plan in the event of connectivity or routing issues that occur without notice and which disrupt the hotline service in any given state or territory.

3.5 Develop and maintain contingency plans to manage operations in the event of downed networks, natural disasters, or public emergency, with a sufficient level of well-trained counselors and reliable, efficient technology services. Each line of service (phone, text, chat) shall have a backup redundancy from both a routing and service provision perspective. Ensure that all staff and key stakeholders are aware and informed of appropriate policies and procedures regarding the disruption of hotline operations.

3.6 Submit to the COR any proposed changes to the hotline, text, and web chat networking systems prior to implementation of modifications.

Task 4. Staffing and Hotline Operations Training Requirements and Materials

The Contractor shall:

4.1 Recruit, employ, orient, train (including technology training), and supervise all necessary personnel, to support the hotline operations. All staff must possess the educational qualifications, experience, expertise, and personal characteristics needed for effective performance of the specific duties assigned.

4.2 Have demonstrated knowledge, understanding, and at least 5 years of organizational experience and recognized expertise providing services for a similar project, and who have provided, and trained health providers on, psychosocial support, evidence-based information, brief intervention, and resources and referrals via telephone, text, and web chats, to pregnant or postpartum persons experiencing mental health conditions and their support persons/loved ones.

4.3 Provide key personnel. Key personnel are expected to serve for the life of the contract, or until replacements with the required education and experience are nominated by the Contractor and accepted by HRSA.

In addition, the Government reserves the right to revise key and non-key designation during the task order performance, including requiring the identification of additional key personnel. COR and CO approval is required prior to onboarding of replacement or new key personnel. This shall help to ensure continuous uninterrupted support is provided.

Requests for approval of substitutions/replacement of key personnel shall be submitted to the CO and COR thirty (30) calendar days prior to enactment of any proposed changes. Requests shall be submitted in writing and include:

• The circumstances necessitating the proposed substitution.

• A complete resume of the proposed new personnel.

• Resumes shall include a narrative of past jobs, and relevant accomplishments. The resumes should be very explicit and use the job history to demonstrate how the person applied their skills and education.

• Any other relevant information necessary to evaluate the impact of the prospective substitution on the program requested by the COR and CO (including proposed rate changes).

Approval or review results will normally be given within ten (10) business days. The Contractor shall not replace any key personnel without the written consent of the CO.

For purposes of this effort, related experience includes experience in a technical field directly related to the labor category being proposed. Additionally, all degrees shall be from accredited institutions. The specific education and experience requirements for Key Personnel are included in Attachment J.

There are four (4) Key Personnel positions that be included in the final Contract. The following Contractor personnel are designated as Key for this requirement. Note: The Government may designate additional Contractor personnel as Key at the time of award.

• Project Director

• Hotline Service Manager

• Data Analyst/Quality Improvement Specialist

• Financial Manager

4.4 Ensure that trained qualified counselors are available twenty-four (24) hours a day, seven (7) days a week, and 365 days a year to respond to callers, texters and web chatters, to the hotline. Specifically, counselors shall provide immediate psychosocial support, evidence-based information, brief intervention, and resources and referrals for maternal mental health and substance use disorder treatment and recovery support services to pregnant and postpartum persons and their loved ones.

Counselors shall reflect the diversity of populations that will engage in hotline services across the U.S.

including racial, ethnic, age, sexual orientation, gender identity, and geographical diversity.

4.5 Provide hotline services in both English and Spanish at minimum. Ensure there is at least one live Spanish speaking counselor on every shift.

Also, the Contractor shall have access to interpreter services to provide services in other languages, per Title VI of the Civil Rights Act of 1964, Executive Order 13166, "Improving Access to Services for Persons with Limited English Proficiency,” and, in concert with industry standards, such as the National Council on Interpreting in Health Care national standards: https://www.ncihc.org/ethics-and-standards-of-practice.

4.6 Recruit, employ and retain qualified counselors with these minimum qualifications, unless waived by https://www.dol.gov/agencies/oasam/regulatory/statutes/title-vi-civil-rights-act-of-1964#:%7E:text=No%20person%20in%20the%20United,activity%20receiving%20Federal%20financial%20assistance.

https://www.justice.gov/crt/executive-order-13166 https://www.justice.gov/crt/executive-order-13166 https://www.ncihc.org/ethics-and-standards-of-practice https://www.ncihc.org/ethics-and-standards-of-practice the CO and COR in specific situations. Counselors shall:

• Have and maintain a current state license or state certification to practice as a counselor. They must have adequate knowledge of the state laws governing mental health issues and clinical practice for the population they are serving. If such licensure/certification is not available in that state, the individual shall hold appropriate certification from a recognized national certification organization or board (i.e., passing a nationally recognized exam).

• Complete a certification in Perinatal Mental Health within four (4) weeks of Contractor personnel onboarding to contract. The Contractor shall provide documentation (i.e., email attestation to COR) for each Contractor showing the specialized training has been completed.

Counselors shall possess the depth and breadth of expertise, and a nuanced understanding, of mental health conditions that specifically affect pregnant and postpartum people. This must include expertise in identifying signs, symptoms, causes, risk factors, and evidence-based treatment and recovery support services for pregnant and postpartum people.

• Have or be covered by professional liability insurance coverage of at least $1,000,000 per occurrence; $3,000,000 aggregate.

• Qualified counselors must include an array of the following professionals:

o Certified peer support specialists who have lived experience with a perinatal mental health condition, and who have a current state certification or appropriate certification from a recognized national certification organization or board.

o Licensed health care professionals who work in maternal and child health, such as nurses, nurse midwives, physicians, pediatricians, psychiatrists, or certified doulas or childbirth educators.

o Licensed mental health clinicians, such as professional counselors, social workers, psychologists, psychotherapists, or marriage and family therapists.

4.7 Ensure that clinical mental health supervision and consultation is available (24 hours a day). Clinical mental health supervision/consultation is used to ensure that adequate knowledge of state laws is appropriately integrated into the delivery of hotline services, to be available for counselors to elevate complex or high-risk clinical needs of help seekers, and to provide clinical supervision including addressing the secondary stress/reactions of counselors.

The minimum qualifications for a clinical mental health supervisor are to have a master’s degree or higher in a mental health field and hold a professional licensure in good standing. The clinical mental health supervisor must have documented clinical supervision training, documented hours of qualified clinical supervision, a minimum of five-year post-master’s experience in mental health services and hold a Certification in Perinatal Mental Health.

4.8 Develop and maintain ongoing standardized orientation and training for counselors to ensure that help seekers receive high quality, culturally and linguistically responsive hotline services. HRSA will provide existing training curriculum. The successful contractor will evaluate these materials, make recommendations for any updates to HRSA, and update materials based on HRSA’s approval.

Orientation and training shall include, but is not limited to, best practices in telephone, text, and web chat counseling, including help seeker privacy and safety issues; basic suicide prevention training;

maternal mental health and substance use disorder prevention, identification, and intervention; best practices in equity, diversity and inclusion, such that counselors can effectively and empathetically handle the anticipated wide diversity of help seekers and how they may vary in their presentation of struggle/conflict/trauma and help seeking behaviors; use of the telecommunications, technology, and resource and referral directory and systems, including the ability to do immediate bi-directional warm transfers to an appropriate crisis line, for a help seeker in crisis, such as someone who is suicidal, at risk for or experiencing intimate partner violence, or has overdosed; and providing trauma-informed support.

4.8.1 Ensure that counselors performing phone, text, or chat counseling have specialized experience and training in phone, text, or chat counseling. Specialized experience includes being trained in providing online emotional support, creating a safe and empathetic environment, and validating the texter’s, caller’s or web chatter’s experience and building rapport through these virtual modalities.

4.8.2 Ensure counselors receive the specialized training or Certification in Perinatal Mental Health during training/orientation period, if not already possessed by the counselor.

Examples of providers of certification in perinatal mental health include Postpartum Support International and 2020 Mom.

4.9 Retain and provide upon request to the COR, an Excel spreadsheet list of all counselors to include counselor name, degree, license status, status of specialized training or certification in perinatal mental health, full business address, land and cell phone and fax numbers, email address, and the expiration dates for professional license(s) and professional liability insurance. In addition, retain and provide upon request to the COR, copies of each counselor’s resume, and a summary of the findings of a background check in accordance with the Contractor’s company policy. Copies of all documents shall be retained by the Contractor and provided to the COR upon request via electronic file within seven

(7) business days of request.

4.10 Develop and maintain ongoing standardized orientation and training to ensure that all personnel working under this contract have the information and skills needed to effectively perform their duties.

This includes, but is not limited to, the relationship to service provision; use of the telecommunications and information system; a workplace where diversity is respected, and equity and inclusion are valued, as evidenced by company surveys; and that interactions between and among staff and help seekers occur through the lens of trauma-informed and equitable practices and policies.

https://www.postpartum.net/professionals/certification/ https://www.postpartum.net/professionals/certification/ https://www.2020mom.org/certificate-training

4.11 Complete the ICMI Certification Assessment and Contact Center Site Certification Program within twelve (12) months of completing the kick-off meeting. A national certification or accreditation shall be maintained for the duration of contract.

4.12 Ensure all Contractor (and/or any subcontractor) employees obtain a background investigation commensurate with their position sensitivity designation that complies with Parts 1400 and 731 of Title 5, Code of Federal Regulations (CFR). The following position sensitivity designation levels apply to this solicitation/contract:

Non-sensitive Tier 2

Non-sensitive Tier 2 is a suitability investigation that is conducted by the Defense Counterintelligence and Security Agency which is part of Department of Defense. It consists of fingerprints and completing the SF-85P.

4.13 Develop and provide a written Training and Orientation Plan to include topics, timelines and curricula for all standardized staff orientation and training (for counselor and non-counselor staff) and submit to the COR within ninety (90) days after the kickoff meeting. The Training and Orientation Plan shall be updated as often as required but annually at a minimum. All subsequent Training and Orientation plans shall be provided to the COR within 30 days of completing revisions for COR review and feedback.

4.14 Provide all standard orientation and staff training materials/curricula to the COR within six (6) months after the kickoff meeting.

Task 5. Resource and Referral Directory

5.1 Develop, or if existing, update and maintain an online and continuously updated comprehensive, searchable, multi-lingual, up to date, nationwide, state-by-state, and U.S. territories resource and referral directory to ensure that hotline counselors can effectively refer pregnant and postpartum callers or their loved ones, to local maternal mental health and substance use disorders resources, providers, services and supports, or those available by telehealth. Having this directory online also allows the public a “self-service” option for identifying resources.

5.1.1 Provide the following resource and referral provider source types at a minimum:

• Licensed perinatal mental health and substance use professionals such as licensed counselors, psychotherapists, psychologists, social workers, marriage and family therapists, substance use counselors or treatment programs, psychiatric and/or addiction psychiatry providers, especially any reproductive psychiatrists.

• Childbirth professionals, including childbirth educators, birth and postpartum doulas, and https://www.icmi.com/consulting/site-certification lactation consultants.

• Providers offering tele-behavioral health services.

• In-person or virtual support groups.

• Other maternal peer support services.

• At a minimum, resources and referrals are required to be available in English and Spanish.

For the mental health provider directory, the Contractor shall be able to make referrals to providers who speak other languages, as providers indicate that availability. As the Contractor and HRSA track metrics and usage trends over time, the Contractor shall identify resources and referrals in other languages as indicated by help-seeker background.

5.1.2 Provide to the COR an electronic version of the provider resource and referral directory four

(4) months after the kickoff meeting, annually, and upon request from the COR. Include a summary of source types and amounts (e.g., number of therapists, doulas, substance use counselors, etc.). The resource and referral directory shall be online within seven (7) months after the kickoff meeting.

5.2 Ensure that referrals shall be offered in the help seeker’s local area or through telehealth or virtual supports, considering the help seeker’s financial means and available health insurance; and preferences for age, gender, ethnicity, and language-specific resources, whenever possible.

5.3 Ensure the capacity for counselors to provide immediate bi-directional warm transfers to and from an appropriate crisis line, for a help seeker in crisis, such as someone who is suicidal, at risk for, or experiencing, intimate partner violence, or has overdosed.

5.4 Develop and provide a plan to establish and ensure effective communication with other national, state and local resource and referral networks, to the extent possible, including 211, SAMHSA’s National Treatment Locator, HRSA’s Find A Health Center, HRSA’s Mother To Baby service, and other perinatal mental health provider directories, in order to maintain, extend and continuously update an existing resource and referral directory. This shall include engagement with the National Hotline Consortium, to facilitate communication and coordination among national hotline providers, and to remain informed of best practices, innovations, cutting-edge research, and trends in the industry.

5.4.1 Submit the draft plan to the COR within ninety (90) days after the kickoff meeting. A final plan is due within six (6) months following the kickoff meeting. Provide progress reports of activities and findings to the COR on a quarterly basis.

5.5 Revise and update resource and referral service providers on a rolling basis to ensure services are still available and appropriate.

Task 6. Partnership Development and Management

Since HRSA expects the Hotline Operations Contractor to possess recognized expertise providing psychosocial support, resources and referrals to individuals experiencing maternal mental health and substance use conditions and their loved ones, it is expected that the Contractor already has well-developed contacts in the field of maternal mental health. The Hotline Operations Contractor – in coordination with the Communications Contractor – shall determine if they focus their partnership development efforts with Target Audience #3 (listed under Section II. Purpose), “Health and social and human services providers who interact frequently with the target population.”

Note, the purpose of the Hotline Communications Contract is to obtain Communications and Marketing services to promote widespread national awareness and use of the National Maternal Health Hotline.

The Hotline Operations Contractor shall help amplify campaign materials through partnership development, outreach, and management. All amplification efforts shall be approved by the COR before posting or disseminating.

The Contractor Shall:

6.1 Develop and provide a Partnership Development and Management Plan to establish, facilitate, and manage timely, ongoing outreach, partnerships and communication with key partners who can 1) help promote the hotline and 2) provide feedback and perspectives on hotline operations from the maternal health field. This task shall be carried out in collaboration and meetings with the Hotline Communications Contractor, to ensure complimentary and not duplicative outreach to partners.

6.2 Submit the plan to the COR within ninety (90) days after the kickoff meeting. Conduct routine meetings with key partners and provide progress reports of activities and findings to the COR on a quarterly basis.

Task 7. Use of Plain Language Guidelines and Other Government Laws and Regulations for all Products

The Contractor shall:

7.1 Follow the federal Plain Language Guidelines when developing products. The Plain Language Act of 2010 requires federal agencies to create communications that are clear and understandable to the public.

7.2 Produce content that follows federal plain language guidelines. All text content shall aim for a Flesch-Kinkaid

Reading Ease score of at least 60. HRSA’s Office of Communications’ liaisons use Readable to review, update, and score content. The Contractor shall work with the COR and program communications liaisons and use Readable to review, score and enhance the content.

7.3 Use PlainLanguage.gov’s Checklist for Plain Language and HHS’s Plain Writing Checklist as guidelines.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fplainlanguage.gov%2Fguidelines%2F&data=05%7C01%7CDLevinson%40hrsa.gov%7Cf524fbd16f364721732d08da47c9b157%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C637901229172500009%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=NrhVtQRVj87g7oEnbGmaLq4n%2B5oWyjprui2sTX0WfUI%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Freadable.com%2Fblog%2Fthe-flesch-reading-ease-and-flesch-kincaid-grade-level%2F&data=05%7C01%7CDLevinson%40hrsa.gov%7Cf524fbd16f364721732d08da47c9b157%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C637901229172500009%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=pM2y1KEStAidsJnKvzZ8vu4Wy51vpq1T8YMxXIjVHXQ%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Freadable.com%2Fblog%2Fthe-flesch-reading-ease-and-flesch-kincaid-grade-level%2F&data=05%7C01%7CDLevinson%40hrsa.gov%7Cf524fbd16f364721732d08da47c9b157%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C637901229172500009%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=pM2y1KEStAidsJnKvzZ8vu4Wy51vpq1T8YMxXIjVHXQ%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Freadable.com%2F&data=05%7C01%7CDLevinson%40hrsa.gov%7Cf524fbd16f364721732d08da47c9b157%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C637901229172500009%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=S6uwGk8Od0r7o78msdZcS%2Fo6ptpB7u97tSYaBSh1mV8%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.plainlanguage.gov%2Fresources%2Fchecklists%2Fchecklist%2F&data=05%7C01%7CDLevinson%40hrsa.gov%7Cf524fbd16f364721732d08da47c9b157%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C637901229172500009%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=Nyu93GvxXXnL%2BlygkNsHRAybdpEMpOfa1dTJkg2Rgzs%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.hhs.gov%2Fweb%2Fbuilding-and-managing-websites%2Fmanaging-websites%2Fplain-writing-checklist%2Findex.html&data=05%7C01%7CDLevinson%40hrsa.gov%7Cf524fbd16f364721732d08da47c9b157%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C637901229172500009%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=Wp6KwoWuIAhyFuEL%2F1rHFY83dad7KXjJMT7FSl0pPFE%3D&reserved=0

7.4 Ensure that all materials adhere to federal copyright laws including the citation of sources in endnotes or footnotes; obtaining written permission to reproduce, reprint, or adapt existing materials used in the creation of materials under this contract; and including credits for images, which include photographs, pictures, illustrations, tables, charts, figures, and graphs.

7.5 Ensure that all materials adhere to the Government Printing and Binding Regulations, including the prohibition on commercial advertising which says, “No Government publication or other Government printed matter, prepared or produced with either appropriated or non-appropriated funds or identified with an activity of the Government, shall contain any advertisement inserted by or for any private individual, firm, or corporation; or contain material which implies in any manner that the Government endorses or favors any specific commercial product, commodity, or service.” -- (Title III--General Provisions, 13. Advertisements, Commercial.)

7.6 Ensure that all materials do not contain any non-federal logos (since logos are a form of institutional advertising); those materials do not contain contact information for non-federal organizations, except the website address for informational purposes; and that all materials do not contain any contact information for individuals.

7.7 Ensure that all materials do not contain the name of the contractor or subcontractors since this is also a form of advertising.

7.8 Ensure that all materials adhere to the prohibition against referring to lobbying in materials produced with appropriated funds. The prohibition against lobbying also includes grassroots lobbying, which is advocating for a change in legislation at the federal, state, or community level.

Task 8. Policies, Procedures, Protocols

8.1 Establish and ensure policies, procedures and protocols are in place for all hotline systems, operations, resource and referral directory and systems, and personnel. Develop and provide a plan and internal repository with access for designated hotline employees.

Submit via electronic mail all final written policies, procedures, and protocols, including the plan to establish and maintain an internal repository with access to all designated hotline employees, to the COR within six (6) months after the kickoff meeting, unless specified otherwise.

Policies, procedures, and protocols shall include:

8.1.1 Standard Operating Procedures for all hotline business operations and functions. This shall include the following at a minimum:

• Policies, procedures and protocols for ensuring reliable and effective administrative, technology, communication, data collection and reporting, quality improvement, financial management operations function 24 hours a day, 7 days a week, 365 days a year.

• Policies explicitly defining telephone, text and web chat access procedures and system back-up procedures.

• Policies and procedures for the training, coaching, and supervising of counselors.

• Policies and procedures for addressing and resolving inappropriate staff engagement/handling of help seekers.

8.1.2 Standard Operating Procedures for Counselors. In addition to being oriented and trained on how to use the telecommunications, technology, and resource and referral directory and systems to ensure efficient response to help seekers (i.e., hotline operations), counselors shall also be oriented and trained on standards for:

• The Counselor requirements under this Contract: Help seeker engagement; provision of psychosocial support, brief intervention, evidence-based information, resources, and referrals for maternal mental health and substance use disorders.

• Additional training topics, at a minimum, must include:

o Best practices in telephone, text, and web chat counseling, including help seeker privacy and safety issues. An example of a provider of such best-practice training is the International Council for Helplines o Basic suicide prevention training o Maternal mental health and substance use disorder prevention, identification, and intervention;

o Best practices in equity, diversity, and inclusion, such that counselors can effectively and empathetically handle the anticipated wide diversity of help seekers and how they may vary in their presentation of struggle/conflict/trauma and help seeking behaviors o An emergency response protocol to assist help seekers in immediate crisis and the ability to do immediate warm transfers to an appropriate crisis line, for a help seeker in crisis, such as someone who is suicidal, at risk for, or experiencing, intimate partner violence, or has overdosed o Providing trauma-informed support.

• The Contractor shall ensure that counselors performing phone, text or chat counseling have specialized experience and training in phone, text, or chat counseling.

• The Contractor shall provide specialized training or Certification in Perinatal Mental

Health, if not already possessed by the counselor.

8.1.3 Orientation and Training.

• All Staff and personnel shall be oriented and trained on Standard Operating Procedures, https://councilforhelplines.org/training/ as per job requirements as Counselors or staff providing all other hotline business operations and functions.

8.1.4 Surge Capacity.

• Develop and maintain procedures to handle sudden large unanticipated increases in calls, texts, and web chats. Ensure the capacity to respond to surges in demand for hotline services and identify strategies to address contingencies, such as in response to national media coverage (e.g., May is Mental Health Awareness Month, tragic perinatal loss of famous person), national disasters or public emergencies, while ensuring uninterrupted service in systems and staffing plans.

• Use recorded messages only when absolutely necessary.

8.1.5 Emergencies.

• Develop and maintain a comprehensive disaster preparedness and disaster recovery plan that includes contingencies for continuity of services, in the event of downed networks, natural disasters or public emergencies. Key personnel or their back-ups are expected to be available by mobile phone 24 hours a day, seven (7) days a week for response coordination and oversight to continuity of operations during emergencies.

8.1.6 Follow-up with help seekers- Outbound Work.

• Establish policies and procedures for the provision of follow-up services for callers, chatters and texters. Policies should include the groups of individuals that will be offered services (or if all will be offered), tracking of contacts, timeframes and frequency for follow-up services (e.g., services offered for 6 months, once a month, 3 attempts per contact before closing service). At minimum, any individual that reports emotional distress/crisis or if the call, chat, or text responder identifies the need for ongoing care (e.g., verification of linkage to resources, upcoming reported stressors or major life events), follow-up shall be offered with parameters of program.

• Follow-up is not required in cases of intimate partner violence where privacy and confidentiality are critical to help-seeking measures for victims.

8.1.7 Other Outbound Work.

• Establish policies and procedures for other outbound work the Contractor will conduct. This will include: when, how, and under what circumstances counselors call 911 in a help-seeker’s local area in an imminent danger situation, overdose, suicide in progress, medical emergency, etc.; outreach to providers to ensure the Resource and Referral Directory is updated; outreach to resources to ensure social or behavioral health service availability;

and any potential outreach on behalf or an original caller or third-party caller for supportive care.

8.1.8 Routine Active Monitoring of Hotline Systems

• Establish a routine active monitoring plan to confirm hotline system functionality as well as monitoring call and text service of all associated toll-free numbers and web chat. Any identified system deficiencies or potential issues shall be promptly reported to IT Project Manager, COR, and other appropriate stakeholders for further investigation and resolution.

The Contractor shall submit the plan to the COR within ninety (90) days after the kickoff meeting.

8.1.9 System Issue Response and Resolution

• Establish a clearly defined process for receiving, acknowledging, and categorizing system issues reported by users or identified through monitoring activities. Upon identification of a system issue, the Contractor shall report the issue to the IT Project Manager, COR, and other appropriate stakeholders and initiate an investigation to diagnose the root cause.

Establish a resolution timeline based on the severity and impact of the issue. Establish clear and routine channels to communicate progress updates and resolution timelines to the appropriate stakeholders. Upon resolving a system issue, conduct appropriate testing and validation to ensure the problem is fully resolved and the system is functioning as intended.

Submit a report of all issues including the steps taken for resolution. Submit the plan to the COR within ninety (90) days after the kickoff meeting.

8.2 Review all policies, procedures, and protocols annually to identify any need for updates or revisions.

HRSA shall be notified of policy changes within fourteen (14) days of occurrence and receive a written update of all changes on an annual basis at the beginning of each period of performance.

Task 9. Data Collection, Quality Improvement, and Reports

While collecting the data, the Contractor shall use industry best practice, defense-in-depth security4 and privacy controls to safeguard the confidentiality, integrity, and availability of systems and data based on applicable National Institute of Standards and Technology (NIST) standards.

4 Defense in Depth (DiD) refers to an information security approach in which a series of security mechanisms and controls are thoughtfully layered throughout a computer network/system to protect the confidentiality, integrity, and availability of the network/system and the data within.

For the purposes of this contract, the Contractor is assumed to own and manage the individual client level data collected. For the purposes of quality control, hotline operational improvements, performance measures, and capacity management, only extracted de-identified datasets shall be submitted to HRSA upon request.

Specifically, the Contractor shall:

9.1 Provide to the COR a Monthly Data and Progress Report, by the fifteenth (15th) of each month, to manage, monitor and enhance hotline, text, and web chat operations. This shall include Dashboard Reporting of monthly trend, quarterly trend, and annual trend data; analysis and explanation of required key performance indicators, utilization metrics, and continuous quality improvement. The monthly report shall also include status updates on the Key Project Management elements: Workforce Management, Fidelity of Workforce Training, Resource and Referral, Quality Management, Technology Management, Partnership Development and Management, Reporting and Communications, and Financial Management.

The monthly data and progress reports will also provide analysis for HRSA and be used by the Contractor to maximize workforce management; quality management; technology management; reporting and communications; and financial management.

9.2 Ensure continuous operations of the telephone, text, and web chat networks through ongoing evaluation of operating systems, including review of all data and real-time monitoring. Ensure that policies and procedures that address responding to any disruption of operations and providing information to the COR are available upon request.

9.3 Collect and report on basic de-identified help seeker demographics (optional for help seekers to provide) that includes:

• Age

• Race/ethnicity

• Gender identity

• Geographic location (i.e., rural/urban/suburban)

Note: PII is not validated – all information is voluntary.

9.4 Collect and report on other utilization metrics monthly that include at a minimum:

• State/Territory from which call, text, web chat was received

• Help seeker type, i.e., if the help seeker was pregnant or postpartum (“calling for self-pregnant”

“calling for self-postpartum”) or the support person/loved one (or “calling for someone else”)

• Types of ancillary needs identified by the help seeker (e.g., not a primary need for mental health services, but rather needs related to housing, food insecurity, employment, personal safety, childcare, transportation, and education).

9.5 Define key performance…