B01 Attachment 2 Draft QASP.docx

Quality Assurance Surveillance Plan (QASP) Version – July 2025 Version 1.0

For: Division of Environmental Health Services (DEHS)

Contract Number: <upon award, enter contract number>

Contract Description: Tribal Injury Prevention Cooperative Agreements Monitoring Contract (TIPCAP)

Contractor’s Name: < upon award, enter name of contractor > (hereafter referred to as the contractor).

1. Introduction The Quality Assurance Surveillance Plan (QASP) contains the high-level technical and professional requirements for Tribal Injury Prevention Cooperative Agreements Monitoring Contract (TIPCAP) strategies needed to manage and provide the proper quality of information technology support rendered by the Contractor. It focuses on “how” service quality will be delivered along with targets in the form of AQL’s. These AQL’s define the parameters for the services provided.

2. Work Requirements The detailed work requirements of the Tribal Injury Prevention Cooperative Agreements Monitoring Contract (TIPCAP) contract are set forth in the Performance Work Statement (PWS).

In brief, the work requirements correspond to the following categories:

· Cooperative Agreement Grantee Quarterly Newsletter

· Injury Prevention Website Support

· Cooperative Agreement Program Conference Calls

· Ongoing Training and Resource Development in Community-based Injury Prevention

· Worksheets

· Webinars

· TIPCAP Guide

· Technical Assistance

· Evaluation

· Injury Prevention Annual Cooperative Agreement Workshop

· Monitoring Activities

· Site Visits to Part I - Injury Prevention Cooperative Agreement Grantees

· Consultation with IHS Injury Prevention Program

· Reporting

3. Purpose This Quality Assurance Surveillance Plan is a government-developed document used to determine if the contractor’s performance meets the performance standards contained in the contract. The QASP establishes procedures on how this assessment/inspection process will be conducted. It provides the detailed process for a continuous oversight process:

· What will be monitored

· How monitoring will take place

· Who will conduct the monitoring

· How monitoring efforts and results will be documented

The contractor is responsible for implementing and delivering performance that meets contract standards using its Quality Control Plan. The QASP provides the structure for the government’s surveillance of the contractor’s performance and their Quality Assurance/Quality Control (QA/QC) actions to assure they meet contract standards. It is the government’s responsibility to be objective, fair and consistent in evaluating contractor performance.

The QASP is not part of the contract nor is it intended to duplicate the contractor’s quality control plan. This QASP is a living document. Flexibility in the QASP is required to allow for an increase or decrease in the level of surveillance necessary based on contractor performance.

The government may provide a copy of the QASP to the contractor to facilitate open communication. In addition, the QASP should recognize that unforeseen or uncontrollable circumstances might occur that are outside the control of the contractor.

Bottom line, the QASP should ensure early identification and resolution of performance issues to minimize impact on mission performance.

4. Authority Authority for issuance of this QASP is provided under Part 46 of the Federal Acquisition Regulation, Inspection of Services clauses, which provides for inspection, acceptance and documentation of the service called for in the contract or order. This acceptance is to be executed by the contracting officer or a duly authorized representative.

5. Roles and Responsibilities The following personnel shall oversee and coordinate surveillance activities.

Program/Project Manager (PM) or Functional Services Manager (FSM) – The PM/FSM provides primary program oversight, nominates the COR, ensures the COR is trained before performing any COR duties and supports the COR’s performance assessment activities. While the PM/FSM may serve as a direct conduit to provide Government guidance and feedback to the Contractor on technical matters, they are not empowered to make any contractual commitments or any contract changes on the government’s behalf.

Assigned PM/FSM: Timothy Albright, RS, MPH Organization or Agency: Indian Health Service, Division of Environmental Health Services (DEHS) Telephone: (240) 963-5142 Email: Timothy.Albright@ihs.gov

Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also ensure that the contractor receives impartial, fair, and equitable treatment under this contract. Determine the final assessment of the contractor’s performance.

Assigned CO: Andrew Hart Organization or Agency: Division of Engineering Services (DES) Telephone: (206) 375-4443 Email: Andrew.Hart@ihs.gov

Contracting Officer’s Representative (COR) - The COR is responsible for providing continuous technical oversight of the contractor’s performance. The COR uses the QASP to conduct the oversight/surveillance process. The COR shall keep a Quality Assurance file that accurately documents the contractor’s actual performance. The purpose is to ensure that the contractor meets the performance standards contained in the contract. The COR is responsible for reporting early identification of performance problems to the CO. The COR is required to provide an annual performance assessment to the CO which will be used in documenting past performance. The QASP is the primary tool for surveillance of the contractor’s quality program and help the COR to document contractor performance. The COR is not empowered to make any contractual commitments or to authorize any contractual change on the Government’s behalf.

Contractor Representatives

The following employees of the contractor serve as the contractor’s Program Manager and Task Manager for this contract. (Complete this section after the contract award)

Contractor Program Manager - <upon award, enter name> Telephone: <enter number> Email: <enter address>

Contractor Task Manager - <upon award, enter name> Telephone: <enter number> Email: <enter address>

Other Key Contractor Personnel - <upon award, enter name or delete these lines if not applicable> Title: <enter title> Telephone: <enter number> Email: <enter address>

6. Performance Requirements and Method of Surveillance

6.1. Contract Surveillance

The goal of the QASP is to ensure that contractor performance is effectively monitored and documented. The COR’s contribution is their professional, non-adversarial relationships with the CO, PM and the contractor, which enables positive, open and timely communications. The foundation of this relationship is built upon objective, fair, and consistent COR evaluations of contractor performance against contract requirements. The COR uses the methods contained in this QASP to ensure the contractor is in compliance with contract requirements. The COR function is responsible for a wide range of surveillance requirements that effectively measure and evaluate the contractor’s performance. Additionally, this QASP is based on the premise that the contractor, not the government, is responsible for management and QC/QA actions to successfully meet the terms of the contract.

6.2. Surveillance Matrix

The Surveillance Matrix (see sample at Attachment 1) is the list of performance objectives and standards that must be performed by the contractor. This matrix details the method of surveillance and frequency the COR will use to validate and inspect these performance elements. Inspection of each element will be documented in the COR file.

Performance objectives define the desired outcomes. Performance Standards define the level of service required under the contract to successfully meet the performance objective. The inspection methodology defines how, when, and what will be assessed in measuring performance. The Government performs surveillance, using this QASP, to determine the quality of the contractor’s performance as it relates to the performance element standards. The Performance Requirement Summary (PRS) should be used to form the foundation of the COR’s inspection checklist.

6.3. Performance Rating Definitions

The performance ratings below reflect definitions at FAR 42.1503 Table 42-1. The COR will use these rating to evaluate the quality of contractor’s performance.

Performance Rating Definition

Note 1: Plus or minus signs may be used to indicate an improving (+) or worsening (-) trend insufficient to change the evaluation status.

Note 2: N/A (not applicable) should be used if the ratings are not going to be applied to a particular area for evaluation.

7. Performance Reporting

7.1. Corrective Action Report (CAR) Describes how discrepancies are reported and resolved (see sample CAR below).

7.2. Customer Complaint Form (See sample customer complaint form below)

7.3. Performance Assessment Report (PAR) (See sample customer PAR below)

Cooperative Agreement Grantee Biannual or Quarterly Newsletter

Develop and distribute electronic newsletter 2 or 4x year.

Must be 508 complaint

Each funded site must contribute in at least 1 article/year 90%

100%

75% Number of newsletters posted to the website each year. Product is submitted in a timely matter to accommodate multiple iterations.

Was it successfully posted online?

75% of funded sites must have at least 1 newsletter article each year. Article submission communication is tracked with sites that delay submission.

Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Guidance/tips for improvement were provided to IHS IPS Content was provided such as newsletters, announcements, documents, flyers, and verbiage

Quality of the content met the needs of the program

All content and products for the website are 508 compliant

Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

ract line ite

Summary of these calls shall be provided to IHS, PO, and Sites within 30 days

90%

100% 90% of the 2 calls per year were conducted

Call scheduling and administrative items (agenda, reference documents, etc.) were developed and distributed and in a timely manner

Summaries were completed and distributed accordingly for all sites who completed calls

Follow up from each call were tracked and completed Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Ongoing Training and Resource Development in Community-based Injury Prevention

· Worksheets

· Webinars

· TIPCAP Guide

· Technical Assistance

· Evaluation Assists sites in the development of their own IP skillsets.

Worksheets and TA docs are shared with sites and IHS.

Conduct 3 to 4 webinars each year. These must be recorded and shared with sites unable to attend.

TIPCAP Guide shall be updated annually to reflect programmatic changes and updates

Technical assistance requests shall be addressed timely and all products shared with sites and IHS

Evaluation support shall be provided to the sites to include data collection and demonstrate program progress/completion. Conduct data analyses for sites and for compiled, TIPCAP-wide datasets.

95%

95%

90%

Annual needs assessment completed for training and tools Developed training, worksheets, products and tools according to needs assessment Number of completed trainings, program reports and data reports Webinars were planned to meet the needs and interests of grantees and IHS HQ Number of webinars completed

Webinar results and numbers of attendees

Quality of the TIPCAP Guide meets the needs of the grantees and IHS IP Program

Changes for the guide were tracked throughout the year for updates

Technical Assistance products were shared with IHS via email or secure data transfer

Summary of evaluation support to grantees was described in reports

Individual data analysis for sites were completed

Summary data analysis was completed and reported

Number of sites completing reports and datasets.

Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Injury Prevention Annual Cooperative Agreement Workshop

Shall plan (with IHS IPS) and participate in 1.5 or 2 day annual workshop for grantees and POs.

Shall record notes and create report and action items list to be emailed to IHS IPS within 30days.

Contribute and assemble workshop materials in binders or e-form for attendees.

95%

Workshop agenda, location, and attendees

Speakers and guests were recruited and prepped by contractor as to purpose and expectations of presentation/exercise

Workshop evaluation was created, administered, and reported to IHS

Reports and notes are shared via email

Number of materials provided to attendees Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Assist IHS IPS in development of corrective action plan for challenging programs

Assist in compiling programs/projects information to showcase work

Shall conduct annual survey of TIPCAP coordinators on their own performance and provide summary to IHS 95%

Tracking system for the individual sites was developed and updated as needed

Tracking system identified ‘red flags’. Notification to IPS

Action plans were created for challenged programs and follow-up was tracked

Creation of profiles. Number of publications or presentations

Quality of profiles meets the needs of the IHS IP Program

Survey sent to all sites on the contractor performance

Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Provide guidance to each site during visit

Provide notes and summary of that visit to sites, PO, and IHS 90%

Coordination of site visits including agenda, activities, document preparation, were completed and in a timely manner

Number of site visits Site visit follow-up items were tracked and completed Content noted in agenda and notes

Sent via email Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Notes were provided after each call Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Reporting

Shall submit quarterly electronic reports to the COR and IHS IPS.

Develop an annual, cumulative summary report in each year outlining all evaluation components within injury prevention.

90%

Number reports received

Reports for contractor activities, challenges and deliverables were provided

Data compilation from all sites shared In comprehensive report annually, number of reports, including context information for each site

Positive: Document past performance report card, paying particular attention to performance that exceeded the standard

Negative: Document past performance report card, paying particular attention to performance that is below the standard.

Inspection Metrologies:

M1: Inspection of Reports. All reports shall be reviewed upon receipt. The reviewer will report any flaws in the document and categorize the flaws (Editorial, Format, and/or Substance).

Appendix 1 – Surveillance Matrix

CORRECTIVE ACTION REPORT (CAR)

(If more space is needed, use reverse and identify by number)

1. CONTRACTOR

2. CONTRACT NUMBER

3. TYPE OF SERVICES

4. FUNCTIONAL AREA

5. SUSPENSE DATE

6. CONTROL NUMBER

7. DEFICIENCY |_| MAJOR |_| MINOR

FINDING:

FINDING IMPACT:

Please respond with a written corrective action plan that details the corrective action of the cited deficiency, the cause of the deficiency, and actions taken to prevent recurrence by Suspense Date in Block 5. If date was not entered in Block 5, the contractor is not required to provide a response.

8. QUALITY ASSURANCE PERSONNEL (COR)

TYPED NAME AND GRADE

SIGNATURE AND DATE

9. ISSUING AUTHORITY

TYPED NAME AND GRADE

SIGNATURE AND DATE

10. COR RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND ACTION TAKEN TO PREVENT RECURRENCE

11. COR DETERMINATION

|_| ACCEPTED |_| REJECTED

12. CLOSE DATE

CUSTOMER COMPLAINT RECORD

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

PERFORMANCE ASSESSMENT REPORT (PAR)

(If more space is needed, use reverse and identify by number)

4. QUALITY ASSURANCE PERSONNEL (COR) SIGNATURE AND DATE

I. PERFORMANCE

7. |_| DEFICIENCY (CHECK ALL BOXES THAT APPLY)

|_| NEW

|_| REPEAT

|_| NO DEFICIENCY NOTED

8. SERVICES SUMMARY or PWS PARAGRAPH ITEM REVIEWED

II. CONTRACTOR VALIDATION

11. CONTRACTOR REPRESENTATIVE |_| CONCUR |_| NON-CONCUR

12. CORRECTIVE ACTION ESTIMATED COMPLETION DATE

13. CONTRACTOR REPRESENTATIVE CORRECTIVE ACTION AND PREVENTION OF RECURRENCE OR REASON FOR NON-CONCURRENCE OF COR CITED DEFICIENCY

III. ACTION CORRECTED

14. |_| CONCUR |_| NON-CONCUR COR SIGNATURE AND DATE

15. COR REMARKS (REQUIRED)

6. CONTRACTOR REPRESENTATIVE REMARKS