Attachment D - Questions and Answers.pdf

Attachment D – Questions and Answers

Solicitation #75R60223Q00222

National Maternal Mental Health Hotline

1. The Government indicates that interpreter services are available in about 60 additional languages.

With this being contractor provided, can the Government share call history by language?

Answer: Yes, HRSA will provide call history by primary language upon award. During its first year of operation (May 8, 2022-April 30, 2023), 89% of individuals identified English as their primary language (n=11,929), 4% identified Spanish as their primary language (n=536), and 7% of individuals did not have a reported primary language (n=836), either because they did not provide it to the counselor, the contact was abandoned,1 the contact was closed-unsuccessful, or there was a system error.2

Additionally, the hotline used the translation service for 0.1% of contacts (n=10) to communicate in languages including Portuguese, Vietnamese, Mandarin, Pashto, and Farsi.

1 Abandoned calls are defined as a conversation disconnected by the help-seeker (with intent) to end the conversation connection before entry to the queue and within the queue. This is different from a dropped conversation, which is defined as conversations disconnected due to an obvious or known system error on the hotline telecommunications system.

2 System errors are infrequent, occurring on average in 0.9% of contacts.

2. The Government indicates counselors should offer support in English and Spanish. Can the Government provide a call and text history (metrics) based on English and Spanish?

Answer: Yes, HRSA will provide call history by primary language upon award. During its first year of operation (May 8, 2022-April 30, 2023), 89% of individuals identified English as their primary language (n=11,929), 4% identified Spanish as their primary language (n=536), and 7% of individuals did not have a reported primary language (n=836), either because they did not provide it to the counselor, the contact was abandoned,1 the contact was closed-unsuccessful, or there was a system error.2 Additionally, the hotline used the translation service for 0.1% of contacts (n=10) to communicate in languages including Portuguese, Vietnamese, Mandarin, Pashto, and Farsi.

1 Abandoned calls are defined as a conversation disconnected by the help-seeker (with intent) to end the conversation connection before entry to the queue and within the queue. This is different from a dropped conversation, which is defined as conversations disconnected due to an obvious or known system error on the hotline telecommunications system.

2 System errors are infrequent, occurring on average in 0.9% of contacts.

3. What Commercial-Off-The-Shelf (COTS) are currently being utilized for contact management and digital services?

Answer: The hotline system uses Nice inContact Cloud Contact Center (VoIP) to provide the capability for help seekers to contact the hotline via call and SMS and Salesforce’s GovCloud instance for case management and data collection.

4. What languages will be required for the resource and referral directory?

Answer: 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. What has been the percentage of increase during surges, and is May the only time where surges have historically occurred?

Answer: The hotline has been in operation for a little more than one (1) year. The hotline experienced an uptick in contacts in the days following the suspected postpartum psychosis-related event in Massachusetts on January 24, 2023. The average number of contacts per day increased by 73% in the days immediately following the event (1/25/2023 - 1/31/2023). HRSA expects spikes in contact volume in response to increased national media coverage, (e.g., the tragic perinatal loss of famous person, May is Mental Health Month), campaign of public service announcements or social media, or traumatic events.

For example, in the 2-week period following our hotline 1-year anniversary publicity on May 12, 2023, the average daily contact volume, increased by 20% over the previous full month of April.

6. Is there a minimum/maximum length of time for each training under Optional Task 1?

Answer: No, there is not a minimum/maximum length of time for each training under Optional Task 1.

7. Regarding SOW 3.2.3, can the Government provide the crisis line point of contact information to expedite the bi-directional agreement?

Answer: No, the Government will not be providing the crisis line point of contact information.

8. Does the call center require multi-lingual capability (SOW 3.3)?

Answer: Yes, the call center requires multi-lingual capability. In Section 4.5 of the SOW, the requirement is “Provide hotline services in both English and Spanish at minimum, and 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.”

9. Per SOW 4.9, we recommend that counselor documents (e.g., resumes, etc.) be retained by the contractor and made available to the Government upon request.

Answer: HRSA agrees that the Contractor should retain and provide upon request to the COR all counselors’ hire documents (resumes, licenses, etc.) via electronic file within seven (7) business days of request. This has been updated in Section 4.9 of the SOW.

10. Approximately how many ad hoc reports are anticipated, as mentioned in SOW 9.8? What is the frequency?

Answer: The number of ad hoc requests is hard to anticipate and there may be back and forth between HRSA and the contractor; for example, to ensure accuracy for specialized requests for analysis of data/metrics outside of monthly reports by HRSA or HHS leadership (e.g. weekly metrics related to increased marketing, or spikes in call volume), or Congressional inquiry. Others have been ad hoc information requests related to a unique inquiry about the hotline (e.g., from a HRSA stakeholder, for a 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.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 presentation, or for an anonymous user testimonial, etc.). Ad hoc requests may range from 40 to 100 in a year. They are usually quick turnaround in nature, hence the three (3) business day requirement.

11. One deliverable is listed as “Excel Spreadsheet” in SOW V. Milestones and Schedule of Deliverables. Please clarify.

Answer: The requirement to provide the Excel Spreadsheet has been removed. But note, the contractor shall retain and provide upon request to the COR, an excel spreadsheet list of all counselor information as described in Task 4.9.

12. The deliverable table for “Ad Hoc Report” in SOW V. Milestones and Schedule of Deliverables indicates that the requestor is “COR and designated program officials.” Who are the designated program officials?

Answer: Designated program officials include any other HRSA staff working on the hotline project, for example, the Project Lead, the Project IT Coordinator, Communications Specialists.

13. Will Government allow remote work?

Answer: 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.

14. What are the documentation and current projects currently in process that the new contractor will be taking ownership of during transition-in?

Answer: The new contractor will be taking ownership of all the materials that help a new contractor provide the same level of service and resources to help-seekers, which includes all training materials, and protocols for operations, clinical, and management, and the technology systems (i.e. NICE and Salesforce) themselves.

15. Will the Government provide the required training curriculum and/or approved training as per SOW 4.6, or is the contractor expected to develop the training?

Answer: HRSA will provide all training curriculum and trainings. The successful contractor will evaluate these materials, make recommendations for any updates to HRSA, and update materials based on HRSA’s approval.

16. Can the Government provide the number of calls, texts, and web chat contacts by month and/or annually?

Answer: Yes, HRSA receives monthly data reports from the incumbent contractor. HRSA just released 1-year anniversary data on this webpage: https://mchb.hrsa.gov/national-maternal-mental-health-hotline/anniversary. The most current data is: since launch, the hotline’s professional counselors have had about 13,400 conversations, of which approximately 70 percent were by phone and 30 percent were by text (May 8, 2022 - April 30, 2023). The average contacts per month since launch is 1,100, and broken out by type, that is an average of 772 phone contacts per month and 345 text contacts per month. With increased publicity and marketing at the 1-year anniversary mark, HRSA has revised its estimated volume in the final statement of work to read 2,000 to 2,500 contacts per month. At present, https://mchb.hrsa.gov/national-maternal-mental-health-hotline/anniversary https://mchb.hrsa.gov/national-maternal-mental-health-hotline/anniversary the hotline does not have a web chat feature, however providing that feature is a requirement in the statement of work, at 3.2.2 and 3.2.5.

17. Regarding Task 10. Annual Report:

o Will the government require print and electronic versions to be developed?

o Will the contractor be responsible for the delivery of the AR, regardless of format?

Answer: The Government requires the draft and final Annual Reports to be delivered electronically in Microsoft Word; print is not necessary. Yes, the Contractor is responsible for the delivery of the draft and final Annual Reports as required in Task 10.

18. Per the Task 11. End of Year Meeting:

o Is there a mandated platform for the presentation (Zoom, Teams, etc.)?

o Are there security requirements? How many instances of presentations and locations?

Answer: There is not a mandated platform for the End of Year Meeting. Please note the meeting could be virtual or in person, to be determined closer to the date of meeting. If virtual, a FedRAMP Virtual Meeting solutions (Microsoft Teams and Teams or Zoom) or other HRSA approved platform shall be used.

19. For Task 13.10 Baseline Security Requirements:

o How many existing websites?

o What is the anticipated number of new websites?

o Will the contractor assume all administrative responsibility, including (but not limited to) transferring hosting, maintaining domain registration, and delegation of access?

o How many internal-facing websites?

o Will the contractor assume all administrative responsibility, including (but not limited to) transferring hosting, maintaining domain registration, and delegation of access?

Answer: There are no plans for the development or maintenance of any websites in the SOW. Only HRSA’s web team will have access to our web content management platform.

20. For Task 13.11 Contract Documentation:

o How many different documents (e.g., templates, policies, forms, and other agency documents) will be needed to comply with contract deliverables?

o Are deliverables electronic, physical, or a mixture?

o Appendix B appears to be missing the information on baseline deliverables.

Answer: Contract deliverables will be a mixture of electronic and physical. Please see Appendix D for a list of deliverables associated with the Security Assessment and Authorization Process.

21. Regarding Optional Task 2 – Presentations:

o For 2.3, is there a mandated platform for the presentation (Zoom, Teams, etc.)?

o Are there security requirements?

o For the 2.4 requirement to “Provide an in-person one (1)-hour presentation with slides, at a meeting or conference,” can the Government specify how many times/locations?

o Regarding all the presentations referenced in requirement 2.5, how many times/locations? For the webinars, is there a mandated platform for the presentation (Zoom, Teams, etc.), and are there any security requirements?

o For 2.5.3 and 2.5.4, what is the distribution method for the PPT presentation?

Answer:

o For 2.3 there is no mandated platform, though Zoom is preferred and can host up to 1,000 if needed. The platform may be dictated by the conference hosts and the contractor shall comply with those requirements.

o The meetings/presentations, if virtual, must use a FedRAMP Virtual Meeting solution (Microsoft Teams or Zoom) or other HRSA approved platform.

o For the 2.4 requirement, HRSA may exercise this task up to three (3) times based on stakeholder or partner needs/conferences that present during the year. These presentations will be virtual.

o For the 2.5 requirement, the contractor would conduct all presentations virtually or pre-recorded.

HRSA may exercise each of the presentations listed in 2.5.1, 2.5.2, 2.5.3, and 2.5.4 three (3) times, to be determined as need dictates. The virtual webinar platform may be dictated by the conference hosts and the contractor shall comply with those requirements. Must use a FedRAMP Virtual Meeting solution (Microsoft Teams or Zoom) or other HRSA approved platform.

o For 2.5.3 and 2.5.4, the Contractor shall submit a video file of the pre-recorded presentation, in PowerPoint format. Note, pre-recorded means edited and recorded for this one purpose, and not a recording of a live presentation.

22. Can the Government provide more specifics defining years of experience and the preferred/ required credentials?

Answer: The SOW has included Appendix J with the experience and educational requirement of Key Personnel.

23. For Section 3.2 under Hotline Telecommunications Service, will the Government permit any system downtime windows for maintenance and the upkeep of infrastructure services and operations?

Answer: Maintenance and upkeep activities should be scheduled and planned to minimize system downtime and impact on users.

24. What type of data (including Personal Identifiable Information) is being collected? Is this data stored on a system of record? What will be the retention period of this data? Where is the data being stored?

Answer:

• Help seekers are not required to disclose any PII or additional information. Voluntary information collected from help seekers are first name (aliases are allowed), age range, gender identity, race, ethnicity, location urban/rural classification, location (city, county, or zip code), and phone number.

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

• Help Seeker phone numbers are automatically collected. No prior notice is given to help seekers that their phone number will be collected because by calling in to the hotline, their approval is taken to be implicit. However, help seekers have the option to request their phone number not be stored.

• Lastly, the Hotline System maintains the name and email of hotline counselors who, in order to create user credentials to login to the Salesforce system, must provide their name and email.

• Information is collected and stored within the Contractor’s system’s authorization boundary, in a FedRAMP-authorized system called Salesforce’s GovCloud instance. Salesforce is used for case management and data collection.

• Collected information remains in the Salesforce GovCloud instance. Upon request, the Contractor will provide HRSA with de-identified aggregated data for understanding the metrics of the services delivery.

25. What are the requirements for the use of Cloud platforms and technology?

Answer: Requirements can be found in Appendix B – I. Cloud platforms and technology must have a valid FedRAMP compliant authority to operate (ATO) or be able to obtain a FedRAMP compliant authority to operate.

26. On page 3, the SOW states that the National Maternal Mental Health Hotline shall be performed at the Contractor’s site within the continental U.S. (CONUS). Will the government allow contractors to remotely staff the hotline?

Answer: See the response to Question #13.

27. On page 4, the SOW states that as part of the transition plan activities, there must be a favorable EOD for all contractor staff from HRSA, Division of Security Services. In general, how long does the HRSA EOD process take?

Answer: The timeframe can vary for each background check. Once HRSA receives the information the process begins. Typically, 5 days are provided to complete the investigation paperwork and to get fingerprinted. If that timeline is met and there are no findings during the background investigation, the process can be completed in as little as 7 days. If there are findings during the background investigation, the process will take additional time (up to 30 days) for the applicant to provide necessary information and for a final decision to be made. The investigation that is conducted is a Public Trust investigation that is conducted by DOD/DCSA.

28. On page 6, the SOW indicates that the contractor shall use commercial off-the-shelf (COTS) contact management software, digital services, and industry best practices to route and respond to calls and texts in real-time, and with 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 Appendices and approved by HRSA’s Office of Information Technology (OIT) in coordination with the COR. Many companies and agencies use cloud-based services to provide this functionality. Will the government allow FedRAMP Contact Center as a Service (CCaas) and other technologies? This would ensure that HRSA benefits from (1) improvements in omnichannel technology including advancing analytics, (2) built in redundancy from the cloud-based infrastructure, and (3) the security and privacy protections of a FedRAMP secured system.

Answer: Yes, the government will allow the use of cloud-based solutions. The solution must have a valid FedRAMP compliant (approved) authority to operate (ATO), or if a FedRAMP compliant ATO has not been granted, the Contractor shall submit a plan to obtain a FedRAMP compliant ATO.

29. Can the government please share which technology (COTS product) is currently being used?

Answer: See the response to Question #3.

30. Can the government please provide: 1) monthly volumes by channel; 2) average handle time; 3) service level requirements.

Answer: 1) Since launch, the hotline’s professional counselors have had about 13,400 conversations, of which approximately 70 percent were by phone and 30 percent were by text (May 8, 2022 - April 30, 2023). The average contacts per month since launch is 1,100, and broken out by type, that is an average of 772 phone contacts per month and 345 text contacts per month. However, with increased publicity and marketing at the 1-year anniversary mark, HRSA has revised its estimated volume in the final statement of work to read 2,000 to 2,500 contacts per month. 2) For the period from launch, May 2022 to April 30, 2023, the average call handle time was 19.80 minutes and the average text handle time was

34.80 minutes. Note, the average length of a phone call was 17 minutes, and the average length of a text conversation was 32 minutes. 3) The service level requirements are:

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

31. On page 9, the SOW provides key personnel: Project Director, Hotline Service Manager, Data Analyst/Quality Improvement Specialist, and Financial Manager. There are no qualifications listed for these positions. Will the government please provide minimum qualifications for each key position?

Answer: See the response to Question #22.

32. On page 10, the SOW states that the contractor must ensure that clinical mental health supervision and consultation is available 24 hours a day. Has the government considered making clinical mental health supervisor/consultant a key position? What are the minimum qualifications for this position?

Answer: The clinical mental health supervisor is not required as a key position. The role of the hotline’s clinical supervisor is to ensure that adequate knowledge of state laws is appropriately integrated into the delivery of hotline services, to be available in real time 24/7, 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 this position 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 5 years post-master’s experience in mental health services and hold a Certification in Perinatal Mental Health.

33. Will there be a small business subcontracting requirement for this opportunity?

Answer: Yes, there is a small business subcontracting requirement.

34. Would the government consider the ACCS SIN (561422) for the RFP to allow more competition?

Answer: This SIN was considered. However, it will not be included in the RFQ.

35. [Background, Page 2] Is the contractor responsible for providing the interpreter services?

Answer: Yes, See the response to Question #8.

36. [Background, Page 2] Indicates counselors shall provide phone and chat services in spanish- is there a percentage of counselors required to be bilingual?

Answer: No, there is not a requirement to have a specific percentage of counselors who are bilingual, however, the incumbent contractor ensures at least one live Spanish speaking counselor on every shift.

37. [Sections 4.6 & 4.8.2, Pages 9 & 11, Paragraph 2] Counselors shall complete Perinatal Mental Health- If there is payment required for this course will this be included in ODCs?

Answer: This will be a firm-fixed-price contract. There will be no ODCs. All requirements should be considered in the quote using firm-fixed pricing.

38. [Section 5.1, Page 12, Paragraph 1] Is there a current online database being utilized? What is the platform it is housed on? Is it transferable?

Answer: The current contractor, Postpartum Support International, had a pre-existing provider directory online, that they have updated during the period of the contract. It is housed on PSI’s website:

https://www.postpartum.net/get-help/provider-directory/.

39. [Section 3.3, Page 7, Paragraph 3] Section 3.3 notes "the Contractor shall have the capacity to respond to the anticipated demand (estimated to be an average of 1,600 historical contact volumes, by month, since the May 2022 launch through which date?

Answer: The initial estimate in the draft SOW was based on the first 10 months of operations (May 2022 to February 28, 2023). With increased publicity and marketing at the 1-year anniversary mark, HRSA has revised its estimated volume in the final statement of work to read 2,000 to 2,500 contacts per month.

40. [Section 3.3, Page 7, Paragraph 3] Can the government provide Average Handle Times for the 1600 contacts per month mentioned?

Answer: See the response to Question #30 and Question #39.

41. [Section 3.3, Page 7, Paragraph 3] For the monthly 1600 contacts, can the government break out the contacts by contact type, e.g., phone, text and live chat?

Answer: See the response to Question #30 and Question #39.

42. [Section 3.3, Page 7, Paragraph 3] Section 3.3 refers to operating Hotline "within industry call center service level agreements." Can the government provide any current service level targets e.g., Answer: See the response to Question #30.

43. [Section IV 2, Page 3, Paragraph 4] Hotline Place of Performance is indicated as, "shall be performed at the Contractor’s site within the continental US (CONUS)." Does this allow for remote / telework?

Answer: See the response to Question #13.

44. [Section IV} Contractor site- is remote access a possibility

Answer: See the response to Question #13.

45. [Appendix B] Is there an existing ATO

Answer: Yes, there is an existing ATO for the National Maternal Mental Health Hotline which will expire on 2/28/2024.

https://www.postpartum.net/get-help/provider-directory/

46. [Appendix C] Is existing infrastructure in HHS cloud now? Is it using an existing authorized Cloud Service Provider?

Answer: Yes, the existing infrastructure uses authorized Cloud Service Providers. Nice inContact Cloud Contact Center (VoIP) to provide the capability for help seekers to contact the hotline via call and SMS and Salesforce’s Service Cloud for case management and data collection.

47. [Section 4.6] Who is liable in the event of a data breach? Is liability coverage for data breaches required in addition to Professional liability?

Answer: There is no contractual requirement for the vendor to purchase this type of liability coverage.

However, the vendor is expected to operate and maintain the system in accordance with the Authority to Operate (ATO). In the event of a “data breach”, investigations are performed and if the vendor or their representatives are found to be operating in a manner inconsistent with the system requirements, they may be liable for damages resulting from the lack of performance.

48. [Section 4.12] Please clarify what non-sensitive Tier 2 requires of the contractor?

Answer: That is a suitability investigation that is conducted by DCSA which is part of DoD. It consists of fingerprints and completing the SF-85P.

49. Section 3.3 identifies an anticipated demand of 1,600 contacts per month or 19,000 contacts per year. Do you have statistics on the average call duration?

Answer: See the response to Question #30 and Question #39.

50. Is there an incumbent performing this work? If so, can you provide contract number? If not, how is this need being met today?

Answer: Yes, the incumbent is Postpartum Support International. The current contract number is 75R60221P00027. The contract value is $7,500,000.00. The contract includes the communications work which is not part of this requirement.

51. What is the anticipated timeline for solicitation release?

Answer: The solicitation has been issued.

52. Does the Government plan to hold an industry day?

Answer: No, the Government does not intend to hold an industry day.

53. Section 5.5 identifies several types of resource providers to be utilized in the execution of this program such as perinatal mental health, substance abuse, childbirth, lactation consultants, etc….

Does the Government anticipate identifying specific labor categories (with education and years of experience) to be priced by Industry in an eventual solicitation response?

Answer: The requirement at Section 5.5 is for the Contractor to identify and include these provider types in the online referral directory used to offer referrals to help-seekers described at 5.1. The Contractor is not expected to hire these providers for this task, but rather keep an updated provider directory which counselors can use to make referrals to help-seekers.