B.08.02 Solicitation_Credentialing Services 12.23.2021.pdf

CODE

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until 12:00 PM local time 17 Jan 2022

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X G F 44 - 53

54 - 58 X H 59 - 62 darci.a.rickson.civ@mail.mil

RATING PAGE OF PAGES

7. ISSUED BY

(Date)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

Previous Edition is Unusable 33-134 STANDARD FORM 33 (REV. 9-97)

Prescribed by GSA FAR (48 CFR) 53.214(c)

1 62

(If other than Item 7)

15A. NAME 16. NAME AND TITLE OF PERSON AUTHORIZED TO

AND

ADDRESS

SIGN OFFER (Type or print)

OF

OFFEROR

AMENDMENT NO. DATE

15B. TELEPHONE NO (Include area code) 17. SIGNATURE15C. CHECK IF REMITTANCE ADDRESS

IS DIFFERENT FROM ABOVE - ENTER

SUCH ADDRESS IN SCHEDULE.

18. OFFER DATE

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 700)

2. CONTRACT NO.

W912JC 8. ADDRESS OFFER TO

See Item 7

9. Sealed offers in original and 1 copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if handcarried, in the depository located in

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and

ELECTRONIC SUBMISSION

conditions contained in this solicitation.

10. FOR INFORMATION

CALL:

A. NAME (NO COLLECT CALLS)

DARCI A. RICKSON 785-646-0848

11. TABLE OF CONTENTS

SOLICITATION/ CONTRACT FORM

SUPPLIES OR SERVICES AND PRICES/ COSTS

2 - 3

X I CONTRACT CLAUSES

DESCRIPTION/ SPECS./ WORK STATEMENT

PACKAGING AND MARKING

4 - 18 J LIST OF ATTACHMENTS

INSPECTION AND ACCEPTANCE

DELIVERIES OR PERFORMANCE

X K

REPRESENTATIONS, CERTIFICATIONS AND

OTHER STATEMENTS OF OFFERORS

CONTRACT ADMINISTRATION DATA 21 - 23 X

SPECIAL CONTRACT REQUIREMENTS

OFFER (Must be fully completed by offeror) 24 - 35 X M

L INSTRS., CONDS., AND NOTICES TO OFFERORS

EVALUATION FACTORS FOR AWARD

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

is inserted by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT

(See Section I, Clause No. 52.232-8)

14. ACKNOWLEDGMENT OF AMENDMENTS

(The offeror acknowledges receipt of amendments

AMENDMENT NO. DATE

to the SOLICITATION for offerors and related documents numbered and dated):

FACILITY

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (60 calendar days unless a different period

SOLICITATION, OFFER AND AWARD

X

(X) SEC. DESCRIPTION (X) SEC. DESCRIPTION PAGE(S)

PART I - THE SCHEDULE

26. NAME OF CONTRACTING OFFICER (Type or print) 27. UNITED STATES OF AMERICA 28. AWARD DATE

EMAIL:TEL: (Signature of Contracting Officer)

CODE CODE

B. TELEPHONE (Include area code) C. E-MAIL ADDRESS

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEMS NUMBERED 20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

10 U.S.C. 2304(c)( ) 41 U.S.C. 253(c)( ) (4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN ITEM

24. ADMINISTERED BY (If other than Item 7) CODE 25. PAYMENT WILL BE MADE BY CODE

PART IV - REPRESENTATIONS AND INSTRUCTIONS

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

36 - 43

PART II - CONTRACT CLAUSES

USPFO KS PURCHASING & CONTRACTING

2737 SOUTH KANSAS AVENUE

TOPEKA KS 66611-1170

785.646.0845

FAX:

TEL:

FAX:

TEL:

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

SOLICITATION

6. REQUISITION/PURCHASE NO.5. DATE ISSUED

23 Dec 2021

4. TYPE OF SOLICITATION

SEALED BID (IFB)

NEGOTIATED (RFP)

[ X ]

3. SOLICITATION NO.

W912JC22R0003

Section B - Supplies or Services and Prices

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Job Lead Medical Records Technician

FFP

Lead Medical Records Technician per the PWS.

FOB: Destination

SIGNAL CODE: A

PSC CD: R699

NET AMT

0002 1 Job Credentialing and Records Services

FFP

Credentialing and Records Technician services per the PWS.

FOB: Destination MFR PART NR: Medical Support Services

0003 2 Job Medical Records Technician

FFP

Medical Records Technician per the PWS.

FOB: Destination

0004 Job Cost Reim - Non-Work Site Travel Expense

COST

Cost Reim - Non-Work Site Travel Expense per the PWS.

FOB: Destination

SIGNAL CODE: A

MFR PART NR: Cost Reim - Non-Work Site Travel Expense

ESTIMATED COST

Section C - Descriptions and Specifications

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (PWS)

FOR

Credentialing and Medical Record Technician Contract Positions 12/10/2021

1. General:

1.1. Scope: The contractor shall provide all personnel, tools, materials, supervision and quality control necessary to perform Credentialing and Medical Record Technician services defined in this PWS, except as specified in Paragraph 3.0 as Government Furnished by the Kansas Army National Guard (KSARNG).

1.2. Background: Credentialing and Medical Record Technician services are required to support the assessment of the medical readiness of Army National Guard personnel. The Credentialing and Medical Record Technician services do not require medical certifications to perform as they are administrative task only and do not include clinical decision making. However, a background in medicine for those who have not worked in a credentialing or medical record technician program is extremely valuable. The service goal is to provide program development, oversight and execution in order to execute the Army National Guard medical readiness directives. The end state goal is high medical readiness and deployability for all KSARNG Soldiers.

1.3. Period of Performance (PoP): The period of performance shall be 12 February 2022 – 11 February 2023 (12 months).

1.4. General Information:

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

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

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

1.4.3.1. New Year’s Day

1.4.3.2. Martin Luther King, Jr.’s Birthday

1.4.3.3. Washington’s Birthday

1.4.3.4. Memorial Day

1.4.3.5 Juneteenth Day

1.4.3.6. Independence Day

1.4.3.7. Labor Day

1.4.3.8. Columbus Day

1.4.3.9. Veteran’s Day

1.4.3.10. Thanksgiving Day

1.4.3.11. Christmas Day

1.4.4. Place and Performance of Services: The contractor shall typically provide services between the core hours of 0800 to 1700 on Monday through Friday, except for Alternate Work Scheduled approved by KSARNG, 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. 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.

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

1.4.4.2. Work site: The primary work site is the Kansas Army National Guard Medical Detachment, 18200 W. 87th Street Parkway, Lenexa, KS 66219. Travel to other sites may be required and will be addressed below in paragraph 1.12.

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

1.4.6 Special Qualifications: Several of the positions outlined in the PWS require that the personnel possess special qualifications/training and/or access to specific systems which support their services to that functional branch. Those special qualifications and/or training will be noted within the PWS. Contractors must ensure that any personnel performing under a contract are fully capable of physically conducting basic administrative actions including record keeping, spreadsheet development, active communication, deadline tracking and use of all electronic systems with the ability to be certified and/or qualified through any Government Security or Validation program as needed to conduct the contract services.

1.5. Security Requirements: The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services and/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) or Health Protection Condition (HPCON) change, the Government may require changes in contractor security and/or health protective measures or processes.

1.5.1. All contractors require a Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential and is utilized as an official form of identification to access military instillations and facilities. In addition to being an official form of identification the CAC is the primary means of electronic PIV verification required for utilization of all government inter and intranet devices. Failure to be granted or maintain a CAC will constitute a complete failure of the contractor’s execution of contracted services by that individual and shall be accounted accordingly.

1.5.1.1. In accordance with Department of Defense Manual (Dom) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. The issuance of a CAC will be based on four criteria: (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 21, 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 03, 2017, and (d) verification of a claimed identity. Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID System (RAPIDS) using the DD Form 1172-2, or the Trusted Associate Sponsorship System (TASS).

1.5.1.2. HSPD-12 Background Investigation Requirements: The contractor shall ensure that all employees complete a Personnel Security Investigation Portal (PSIP) request form, OF-306 Declaration for Federal Employment, SF-312 Non-Disclosure Agreement and request for Background investigation for contractors at the earliest possible date and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward it to the National Guard Bureau (NGB) Personnel Security manager who will initiate the investigation process via the PSIP. 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.

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

The submission process for CAC applications is as follows:

1.5.2.1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA) with a copy of their Driver’s License or Passport, Social Security Card, and Birth Certificate.

1.5.2.2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at:

https://tass.dmdc.osd.mil/tass. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.

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

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

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

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

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

1.5.5. The RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification.

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

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

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

1.5.6. The contractor will obtain a DoD email address for each applicant, including subcontractors. Note: If employees of a contractor lose the privilege to access their DoD email address they lose the ability to access required systems to perform their contracted services or renew their CAC.

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

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

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

1.6.1.3. Complete initial and annual Information Assurance (IA), Cyber Security, systems and facilities security and other communications or access security training as deemed necessary by the COR.

1.6.1.4. Mark and safeguard files, output products and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know. Breach of governmental safeguards for classified, protected or otherwise restricted information of any degree will be evaluated by the COR. The COR will provide the KO with any known breach evaluations within 2 business day. In order to reduce further damage caused by a breach the KO will only provide basic details (e.g. who, when, type of breach) to the contractor. The COR will evaluate any breach against possible damage to the government and pending this may remove access to government systems and facilities including confiscation of a contractors CAC. Loss of access to systems will constitute a contract service failure for that individual and will be accounted for accordingly by the KO.

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

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

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

The contract employee may loss access to government systems including confiscation of their CAC.

1.6.1.8. Maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines per current and applicable laws, regulations and policies. Complete HIPAA and Privacy Act training and provide completion certificate to COR within 5 days of initial hire or within 5 working days of annual recertification.

1.6.1.9. Information Assurance (IA)/Information Technology (IT) Training: All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information

Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DOD 8570.01-M shall be completed upon contract award.

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

(https://public.cyber.mil/training/cyber-awareness-challenge ).

1.7. OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training. Once training is complete, contractors will adhere to KSARNG’s OPSEC Plan. COR will provide copy to all contractors - Level 1 OPSEC training is available at (use Google) https://securityawareness.usalearning.gov/opsec/ or JKO-https://jkodirect.jten.mil/Atlas2/page/desktop/DesktopHome.jsf

1.7.1 iWATCH Training. The contractor with an area of performance within an Army controlled installation, facilities or area shall brief all employees on the local iWATCH program. This local developed training will 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 affected contractor employee and subcontractor employee, to the COR, or to the KO if a COR is not assigned, within 15 calendar days after completion of training.

1.7.2 Anti-terrorism Training: All contracted employees who are hired for a period of over 180 days shall complete AT Level I awareness training within 30 calendar days after contract start date. The Contracting Officer Representative (COR) or Supervisor of the contractor will review certificates of completion for each affected contracted employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 30 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: http://jko.ten.mil/courses/atl1/launch.html. AT Level II (ATOBC) trained officers can also provide an in person briefing.

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

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

1.9. Contractor Human Resource Officer and Human Resource Policies: The contractor will provide a copy of the company’s official Human Resource Policies for review by the KO/COR and any other necessary government office as deemed necessary for review by the KO/COR before award of a contract. Any updates, additions or subtractions to the contract companies HR policies will be provided to the KO/COR within 5 business days of the official change. The KO/COR will not distribute, copy or otherwise publicize the contract company’s HR policies.

The KO/COR will review the contract company’s HR policies for any governmental vs contract conflicts. The KO will notify the contractor of any conflicts to achieve a resolution in favor of the government. The KO/COR will also review the HR policies for company rules of conduct including items like dress codes, work attendance and accountability (clocking) policies, sick leave and paid time off and basic employment rules, rights and benefits.

Where gaps or conflicts exist the KO/COR will insure that either the governmental policies are supplied to the contract company for adoption by those employees performing services under the specified contract or that polices are created by the contract company and issued to the employee to allow for clear rules which will enable the employee to maintain adequate health, safety, ethical and moral good conduct while performing their contracted services. The contactor shall designate a Human Resources Officer (HRO) and provide the contact information and availability to their contracted employees before newly hired employees start providing contract services. The HRO representative will not be an employee performing services under this specified contract. HRO services will be provided by the contractor to their employees outside of the hours of contract services at no cost to the government.

This includes subcontracted employees who will either utilize the contract HRO or be provided a designated subcontract HRO.

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

1.11. Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, actions will be taken against employees for violations of this policy. Such actions may include, but are not limited to, removal from the contract, reduction in benefits, or termination of employment. The Contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at

FAR 22.17.

1.12. Contractor Travel: Contract employees may be required to travel to execute duties consistent with all services described within the PWS as shown below. Specifically, in the event of a mobilization, deployment, unit readiness assembly or Periodic Health Assessment (PHA) the Contractor shall ensure adequate non-clinical Credentialing and Medical Record Technician support is available for travel to locations to best support these activities (i.e. work at armories or CONUS Replacement Centers (CRC)) as directed by the Contracting Officer. If changes to the original work in this PWS arise during the performance of the contract the contractor will notify the COR. If determined to be within the scope of the contract the Contracting Officer will provide a 30 calendar-day notice to the contractor with full description of the need and request a proposal. The Contracting Officer will negotiate a modification to the contract to provide this in-scope work effort. Travel to and from the primary worksite will not be reimbursed.

A Cost Reimbursement CLIN will be included in the contract to reimburse travel expenses only. The travel expenses required under this requirement are between 1-10 out-of-area mission supports and may include the Deputy State Surgeon (DSS) requesting designated specialized training programs outlined in the PWS. The specific dates / locations are based upon schedules not yet published, however these missions are typically no longer than three days each and will encompass lodging, meals and a rental vehicle for those areas not covered by a transit system (rail/metro/shuttle).

The contractor shall be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires COR recommendation for approval and authorization by the KO prior to travel arrangements being made. The contractor may be required to travel to off-site training locations and to ship training aids to these locations in the performance of this contract. The cost of shipping training aids shall be borne by the Government and the contractor will be reimbursed for the costs of shipping training aids in accordance with the JTR and limitation of funds in this contract.

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

2. Definitions and Acronyms

2.1. Definitions

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

2.1.2. Contracting Officer (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3. Contracting Officer's Representative (COR). An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as the direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

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

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

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

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

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

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

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

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

2.2 Acronyms:

2.2.1. AFARS Army Federal Acquisition Regulation Supplement

2.2.2. AR Army Regulation

2.2.3. AT/OPSEC Antiterrorism/Operational Security

2.2.4. CAC Common Access Card

2.2.5. CM Case Management

2.2.6. CFR Code of Federal Regulations

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

2.2.8. COR Contracting Officer Representative

2.2.9. COTS Commercial-Off-the-Shelf

2.2.10 DA Department of the Army

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

2.2.12. DD254 Department of Defense Contract Security Requirement List

2.2.13. DFARS Defense Federal Acquisition Regulation Supplement

2.2.14. DOD Department of Defense

2.2.15. DSS Deputy State Surgeon

2.2.16. DM Disease Management

2.2.17. FAR Federal Acquisition Regulation

2.2.18. FMR Fully Medically Ready

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

2.2.20. HBM Health Benefits Manager

2.2.21. HSS Health Systems Specialist

2.2.22. IA Information Assurance

2.2.23. IMR Individual Medical Readiness

2.2.24. IS Information System(s)

2.2.25. KO Contracting Officer

2.2.26. LOD Line of Duty

2.2.27. OCI Organizational Conflict of Interest

2.2.28. ODC Other Direct Costs

2.2.29. MEDPROS Medical Protection System

2.2.30. MHA Medical Health Assessments

2.2.31. MHS Military Health System

2.2.32. MM Medical Management

2.2.33. MODS Medical Operational Data System

2.2.34. MRDP Medical Retention Decision Point

2.2.35. PHA Periodic health Assessment

2.2.36. PII Personally Identifiable Information

2.2.37. PIPO Phase In/Phase Out

2.2.38. POC Point of Contact

2.2.39. PoP Period of Performance

2.2.40. PRS Performance Requirements Summary

2.2.41. PWS Performance Work Statement

2.2.42. QA Quality Assurance

2.2.43. QAP Quality Assurance Program

2.2.44. QASP Quality Assurance Surveillance Plan

2.2.45. QC Quality Control

2.2.46. QCP Quality Control Program

2.2.47. RCAS Reserve Component Automation System

2.2.48. RN Registered Nurse

2.2.49. TE Technical Exhibit

2.2.50. UM Utilization Management

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

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

3.2. Materials: Basic office supplies

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

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

3.5. Utilities: The Government will furnish the necessary utilities for the contractor to perform services outlined in this PWS to include electricity, internet capabilities, phone lines and other items necessary to maintain an office environment with the exception of when the contract employee is performing telework or traveling for execution of services.

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

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

4.2. Secret Facility Clearance: Not required.

5. Contracting Personnel Performance Requirements

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

5.2 Credentialing. The Contractor shall:

5.3 Read, understand and execute DoD, DA, NG and KSARNG regulations and policies through the application of duties described below or as dictated by the DSS.

5.3.1 Credentialing and Medical Record Technician positions require the use of several DOD web-based electronic data systems; (e.g. Medical Operational Data System (MODS), Medical Electronic Data for Care History and Readiness Tracking (MEDCHART), and Joint Centralized Credentialing Quality Assurance System (JCCQAS)).

5.3.2 MODS includes the following applications:

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

2. Electronic Profile (e-Profile);

3. Medical Data Protection System (MEDPROS);

4. Medical Health Assessments (MHA);

5. MEDPROS Web Data Entry (MWDE) as needed;

5.3.2.1 MEDCHART includes the following applications:

1. Automated Voucher System (AVS);

2. Dental Classification Module (DENCLASS);

3. Electronic Case Management (eCase); and

4. Health Readiness Record (HRR)

5.3.3 Data Entry into the following systems: Medical Operational Data System (MODS), MEDPROS, MWDE, JCCQAS.

5.3.4 Reports to the Chief of Medical Staff or Deputy State Surgeon

5.3.5 Serves as the technical advisor to the Privileging Authority, Credentials Committee/Function Chairperson, and assigned providers on issues related to the Credentialing and Privileging (CP) Program to include at least:

appropriate procedures in accordance with DHA-PM 6025.13, Volume 4 and other directives; accrediting organization (AO) standards; and applicable federal, state, and other mandated regulatory guidance.

5.3.6 Coordinates and implements written policies and procedures applicable to all aspects of the CP Program and all other Clinical Quality Management (CQM) Programs, as appropriate.

5.3.7 Ensures providers’ identification are verified by viewing, and obtaining a copy of, a current valid picture identification issued by a federal or state agency, such as a driver’s license, military identification card, or passport.

5.3.8 Provides technical management, verification and assessments regarding credentials information; processes privileging and medical staff appointment applications; and monitors and tracks licensure, certification and registration status for all privileged providers, as outlined in DHA-PM 6023.13, Volume 4, and for all non-privileged providers as directed by the Chief of Medical Staff or Deputy State Surgeon. Must also ensure evidence exists in the credentials file that establishes the authority by which a non-governmental employee may be granted privileges by the Privileging Authority (e.g., volunteer agreement, information from the Contracting Officer, other).

5.3.9 Collaborates with Clinical Directors/Department Heads to identify, collect, track, trend, and analyze ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE). Facilitates departmental compliance with ongoing monitoring of the medical staff for Credentials Committee/Function review and for recommendations to the Privileging Authority for re-privileging.

5.3.10 Supports the Impaired Healthcare Provider Program as per DHA-PM 6025.13, Volume 3, if/as applicable.

5.3.11 Provides support to Reserve Medical Unit Credentials Committee/Function as needed and as applicable.

5.3.12 Serves as point of contract for fee-exempt Drug Enforcement Administration (DEA) registration and National Provider Identifier (NPI) Type 1 registration.

5.3.13 Serves as the Privileging Authority’s JCCQAS database administrator authorizing user access, education, and training on new CP procedures, processes and policies.

5.3.14 Establishes and maintains current information in the JCCQAS electronic database including co-located units and other assigned military personnel, as needed (i.e., Individual Mobilization Augmentees [IMAs]). Maintain all required credentialing and privileging documentation in the provider’s credentials record relating to clinical performance.

5.3.15 Initiates the credentialing, privileging, and medical staff appointment process. Performs a comprehensive data quality and risk assessment review of the electronic Provider Credentials File and ensures documents are scanned, named in accordance with the standard naming convention, and uploaded to the provider’s credentials record.

5.3.16 Performs relevant National Practitioner Data Bank (NPDB) queries, other applicable queries, and Primary Source Verifications (PSV). Performs risk assessment and authenticates the credentials of privileged medical staff members applying for initial clinical privileges and appointment to the medical staff or other changes in privileges as appropriate. Per the Chief of the Medical Staff/Deputy State Surgeon, assures compliance with validation of non-privileged providers’ credentials, as well as relevant NPDB queries, other applicable queries, and PSV upon in-processing to the organization and with other changes in practice as appropriate.

5.3.17 Maintains a system for internal staff to properly identify healthcare providers practicing at the organization, and to confirm clinical privileges or clinical scope of practice.

5.3.18 Provides ongoing JCCQAS reports on expiring credentials (at a minimum of quarterly), to the Chief of the Medical Staff/Deputy State Surgeon and Credentials Committee/Function.

5.3.19 Serves as point of contract for release of information regarding clinical privileges/practice for healthcare providers who have, or previously had, an affiliation with the organization.

5.3.20 Establishes and supports the creation of the provider profile within the electronic health record (EHR) system in collaboration with the health information technology office to provide access to the EHR upon appropriate credentialing and privileging of healthcare providers.

5.3.21 Ensures protection of and access to Medical Quality Assurance Program material is in accordance with Section 1102 of United States Code, Title 10.

5.3.22 Initiates annual system reviews to identify, analyze, and determine facility and resource capabilities that may impact safe and reliable healthcare of the force. At intervals not to exceed 12 months, a review of facility-specific departmental criteria with appropriate department heads, Credentials Committee/Function is required to ensure criteria are appropriate to support the granting of clinical privileges. The local Master Privilege List (MPL) must reflect facility capabilities.

5.3.23 Performs Medical Records Technician duties when not performing credentialing duties.

5.4 Medical Records Technician: The Contractor shall:

5.4.1 Adhere to the policies and procedures for the preparation, disposition and use of the Army electronic and paper medical records and other healthcare documentation in accordance with Army Regulation 40-66 and :

5.4.1.1 Attend SRP events as determined by the needs of the state and individual Units

5.4.1.2 Ensure all medical documentation received from the Soldier, Medical Readiness NCO or physician office is received and placed in HRR, as well as the Soldier’s Service Treatment Records (STR).

5.4.1.3 Provide dedicated STR assistance in support of medical Case Management.

5.4.1.4 Obtain completed Release of Information Form from Soldiers.

5.4.1.5 Provide maintenance and accountability of Soldier STR in accordance with Army Regulation (AR) 40-66

5.4.1.6 Scan and upload Medical/Dental documents into the Health Readiness Record (HRR) program

5.4.1.7 Organize & File Medical/Dental documents into Soldiers’ hard copy Service Treatment Records.

5.4.1.8 Accurately index uploaded Medical/Dental documents

5.4.1.9 Process all STR requests to include active, and retired/discharged Soldiers as well as Interstate Transfers in a timely manner.

5.4.1.10 Assist in scrubbing MEDPROS data/spreadsheets before SRPs to assist in early identification of non-deployable Soldiers

5.4.1.11 Organize and process Discharged STRs in Record Holding Area to include scanning, indexing and filing

5.4.1.12 Review Order Logs and process accordingly when Soldier’s status changes

5.4.1.13 Complete State Validation Rosters to verify accurate data processing of STRs

5.4.1.14 Adhere to Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines.

5.5. Service Contract Reporting (SCR): Not Applicable

6. Applicable Publications and Forms:

All Army publications can be found online at the Army Publishing Director Home page, Department of Defense G1 portal, National Guard G1 portal and KSARNG G1 portal.

Below is an example list of form labeling for search and evaluation and is not intended to be current or complete and provided only for reference.

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

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

I-9, Employment Eligibility Verification

10/21/2019 https://www.uscis.gov/sites/default/files/files/form/i-9.pdf

DD 441, Department of Defense Security Agreement

02/01/2020 http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm

DD 250, Material Inspection and Receiving Report

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

PSIP request Form March 2018 Internal Process Document

Request for Background Investigation 06/02/2017 Internal Process Document

TECHNICAL EXHIBIT ONE

PERFORMANCE REQUIREMENTS SUMMARY

Credentialing Manager

PO # PWS PARA

PERFORMANCE

OBJECTIVE

PERFORMANCE THRESHOLD

SURVEILLANCE

METHOD &

FREQUENCY

PO 1 5.3.3 Data Entry into the following systems:

Joint Centralized Credentialing Quality Assurance System

(JCCQAS)

Deliverables completed within Performance Threshold

E: Deliverables completed 2 working days from receipt

Periodic Inspection

VG: Deliverables completed 5 working days from receipt

S: Deliverables completed 10 working days from receipt

M: Deliverables completed 15 working days from receipt

U: Deliverables completed 20 or more working days from receipt

PO2 5.3.8 Monitor and track licensure, certification and registration status for all privileged providers

Deliverables prepared by contractor accurately address all aspects of the requirement

E: Completed within 5 working days from receipt with 100% accuracy

Periodic Inspection

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

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

M: Completed within…