DRAFT Medical Case MGMT. PWS.docx

PERFORMANCE WORK STATEMENT (PWS)

FOR

Medical Case Management Services

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform medical and non-clinical case management services, Services, as defined in this PWS.

The primary scope of this contract is to provide comprehensive medical and non-clinical case management for approximately 12,000 to 13,000 closed cases annually resulting in definitive adjudication in support of the medical readiness of the ANG. The contractor shall provide adequate staffing within defined on-site parameters defined elsewhere within this PWS for program management, case analysis/metrics, and quality control measures; assuring the recommendations made by the team are reliable, reproducible, defendable, and timely in accordance with (IAW) applicable guidance. Cases are reviewed for the purpose of ensuring medical readiness for the ANG. Case types and processing requirements are detailed in Paragraph 5 .0. The contractors will interact with providers; Guard Medical Units (GMU); military treatment facilities; recruiters; the ANG; and other certification/waiver authorities within the Air Force (AF) and Reserve Components (RC).

The contractor, in absence of specific guidance on unique circumstances, shall develop a strategy and request approval for implementation on future cases. ANG contract personnel shall utilize the following existing software programs and/or their replacements if phased out during the performance of this contract: Air Force Recruiting Information Support System (AFRISS), Aeromedical Service Information Management System (ASIMS), MHS Genesis, Joint Legacy Viewer, Electronic Case Tracking (ECT), DOD Safe, Physical Evaluation Board Liaison Officer (PEBLO) Account Management (also known as CIB), Aeromedical Information Management Waiver Tracking System (AIMWTS), Physical Exam Processing Program (PEPP), and any future software developed for the program by the Department of Defense (DOD) or Service Components.

This is a non-personal services requirement to provide the necessary level of administrative, professional, and technical support required to facilitate the overall objectives of the ANG medical and non-clinical case management program. The Government shall neither directly supervise contractor employees nor control the method by which the contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor employees. Contractor employees shall be accountable solely to the contractor who, in turn is responsible to the Government. The contractor's management plan shall ensure that employees properly comply with the performance standards outlined in this PWS. It shall be the responsibility of the contractor to manage its employees and to guard against any actions that are of the nature of personal services or give the perception of personal services. If the contractor believes that any actions constitute, or are perceived to constitute personal services, it shall be the contractor's responsibility to notify the KO immediately. Comment by SCHMIDT, JENNIFER L Col USAF NGB SG NGB/SG: Will need help from AQ: non-personal services vs performance based

1.1.1 Objectives

1.2 Background: ANG’s vision for this contract is to support both medical case management and non-clinical programs with a team of highly skilled and trained medical professionals that will review and make recommendations/dispositions on cases supporting the needs of the ANG. The vendor shall provide independent recommendations / dispositions on medical cases by utilizing existing guidance and without the need for extensive oversight or guidance from the respective service. Independent judgment is critical.

1.3 Period of Performance (PoP): The Period of Performance shall be 1 Base Year of 12 months and four 12-month option years.

1.4 General Information:

1.4.1 Place and Performance of Services: The contractor shall provide services between the hours of 0730-1630 on Monday through Friday, except on recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Performance shall be at Air National Guard Readiness Center (ANGRC), National Guard Bureau, Office of the Air Surgeon, 3500 Fetchet Avenue, Joint Base Andrews, Maryland 20762. 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. Teleworking is authorized.

1.4.1.1 Telework:

The Government does permit the contractor to telework in support of this requirement. In furtherance of Continuity of Operations Planning (COOP), a telework program may be enacted to ensure that the Government's mission-critical operations stay operational during times of national emergency or incidents of national significance. Telework shall be at no additional cost to the Government. The Medical Director and contract manager are required to be on site at the Government location during normal business hours.

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

1.4.1.3 The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall 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 from Government property or revoke access to Government systems for misconduct, security reasons, or any overt evidence of communicable disease. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

1.4.2 Recognized Holidays: The Contractor shall not perform services on recognized U.S. holidays. All recognized holidays can be found at: https://www.opm.gov/policy-data-oversight/pay-leave/federal-holidays/. Most Federal employees work on a Monday through Friday schedule. For these employees, when a holiday falls on a non-workday (Saturday or Sunday) the holiday usually is observed on Monday (if the holiday falls on Sunday) or Friday (if the holiday falls on Saturday). The Contractor shall be responsible for knowing when Federal holidays are recognized as this may impact the status of Federal facilities and contractor access to such facilities.

1.4.3 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is 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 days after contract award. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

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

1.4.5 Access and General Protection/Security Policy and Procedures. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the Contracting Officer’s Representative (COR). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by the local installation’s Security Forces, Director of Emergency Services or local Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by DoD, Headquarters Air Force (HAF) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1. The contractor shall obtain base identification and vehicle passes, if required, for all contractor personnel who make frequent visits to or perform work on the Air Force installation(s) cited in the contract. Contractor personnel are required to wear or prominently display installation identification badges or contractor-furnished, contractor identification badges while visiting or performing work on the installation.

2. The contractor shall submit a written request on company letterhead to the contracting officer listing the following: contract number, location of work site, start and stop dates, and names of employees and subcontractor employees needing access to the base. The letter will also specify the individual(s) authorized to sign for a request for base identification credentials or vehicle passes. The contracting officer will endorse the request and forward it to the issuing base pass and registration office or Security Forces for processing. When reporting to the registration office, the authorized contractor individual(s) should provide a valid driver s license, current vehicle registration, valid vehicle insurance certificate, and [insert any additional requirements to comply with local security procedures] to obtain a vehicle pass.

3. During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel and for prompt return of credentials and vehicle passes for any employee who no longer requires access to the work site.

4. When work under this contract requires unescorted entry to controlled or restricted areas, the contractor shall comply with

5. Upon completion or termination of the contract or expiration of the identification passes, the prime contractor shall ensure that all base identification passes issued to employees and subcontractor employees are returned to the issuing office.

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

1.4.5.1. For Contractors Requiring Common Access Card (CAC). For installation(s)/location(s) cited in the contract, contractors shall ensure Common Access Cards (CACs) are obtained by all contract or subcontract personnel who meet one or both of the following criteria:

(a) Require logical access to Department of Defense computer networks and systems in either:

(i) the unclassified environment; or

(ii) the classified environment where authorized by governing security directives.

(b) Perform work, which requires the use of a CAC for installation entry control or physical access to facilities and buildings.

(c) While visiting or performing work on installation(s)/location(s), contractor personnel shall wear or prominently display the CAC as required by the Governing local policy.

Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated Tier 1 (T1) or higher investigation IAW DoDI 5200.46. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial/interim CAC may be issued based on a successfully scheduled T1 with the Office of Personnel Management and a favorable completion of an FBI fingerprint check.

1.4.5.1.1 Homeland Security Presidential Directive (HSPD)-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them and shall process all CAC card applications. The contractor shall ensure that all employees requiring a T1 be vetted by the cognizant security activity Chief, Information Protection (CIP) to ensure a proper investigation is on record. The CIP will process the T1 if needed. 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 investigation may take multiple weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that contractor employees meet CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.

1.4.5.1.2 Contractors and their personnel shall use the following procedures to obtain CACs:

(a) Contractors shall provide a listing of personnel who require a CAC to the contracting officer. The Government will provide the contractor instruction on how to complete the Contractor Verification System (CVS) application and then notify the contractor when approved.

1.4.5.1.3 Contractor personnel shall obtain a CAC from the nearest Real Time Automated Personnel Identification Documentation System (RAPIDS) Issuing Facility (typically the local Military Personnel Flight (MPF)). At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by Social Security Number (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.

1.4.5.1.4 During the performance period of the contract, the contractor shall:

1. Within 7 working days of any changes to the listing of the contract personnel authorized a CAC, provide an updated listing to the contracting officer who will provide the updated listing to the authorizing Government official;

2. Return CACs in accordance with local policy/directives within 7 working days of a change in status for contractor personnel who no longer require logical or physical access;

3. Return CACs in accordance with local policy/directives within 7 working days following a CACs expiration date; and

4. Report lost or stolen CACs in accordance with local policy/directives.

1.4.5.1.5 Within 7 working days following completion/termination of the contract, the contractor shall return all CACs issued to their personnel to the issuing office or the location specified by local policy/directives. A receipt for each returned card shall be provided to the TA/COR.

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

1.4.5.1.6 For an Air Contractor that need access to the Army network this can be done by going to: http://www.us.army.mil and registering as an "Army Guest," with the sponsor being the COR or a COR- designated individual if the COR is ineligible to Serve as an AKO Sponsor.

1.4.5.2 (Reserved) For Contractors that do not require CAC but require access to a DoD Facility and/or Installation. Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Air Force Instruction (AFI) 10-245, AFI 31-101 and Air Force Manual (AFMAN) 31-113), applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by Government representative)

1.4.5.3 Antiterrorism Awareness Level I Training (AT Level I). All contractor employees, to include subcontractor employees, requiring access to US Government installations, facilities and controlled access areas shall complete AT Level I Training within 15 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. AT Level I may be accomplished by a Level I qualified instructor; completing the Force Protection computer-based training (CBT) course on the Advanced Distributed Learning System (ADLS) or Joint Knowledge Online at http://jko.jten.mil. Tracking for each contractor or subcontractor employee is the responsibility of the COR or unit AT Representative. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee to the COR within 15 calendar days after completion of training by each employee or subcontractor personnel.

1.4.5.4 Reserved.

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

1.4.5.6 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 Air Force Infostructure. Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall:

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

1.4.5.6.2 Complete initial and/or annual Information Assurance (IA) training as required by applicable Air Force/ANG policy.

1.4.5.6.3 Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.

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

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

1.4.5.7 Air Force (AF) MyLearning. All contractor employees and associated sub-contractor employees assigned to work on a Government site and/or requiring access to a DoD network will be required to register with ADLS at commencement of services in order to complete the necessary training required of them initially and annually for the duration of the contract (i.e., DoD IAA CyberAwareness, Protecting Sensitive Information, Force Protection, etc.). AF MyLearning website: jets.cce.af.mil/moodle/

1.4.5.8 Information Assurance (IA) Training. All contractor employees and associated sub-contractor employees shall complete the DoD Information Assurance Awareness CyberAwareness Challenge before issuance of network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Air Force training requirements in DoDD 8140.01, DoD 8570.01-M and AFMAN 17-1301 within 180 days of the start of contract performance.

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

1.4.5.10 Requirement for OPSEC Training. In accordance with AFI 10-701, Operations Security, OPSEC PMs/Signature Managers/Coordinators will provide OPSEC training or training materials to contract employees within 30 days of employees’ initial assignment to the contract and prior to having access to any critical information (CI) and annually thereafter. General organizational orientations may need to be supplemented by duty-related orientations in the work center targeted toward specific critical information and vulnerabilities associated with the work. Initial training (OPSE 1301 - OPSEC Fundamentals) is located on the ADLS website and refresher OPSEC training is conducted annually (at Commander's Call). The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training.

1.4.5.11 OPSEC Plan: The contractor shall develop an OPSEC Plan and provide it to the COR or KO within 15 calendar days of contract award to be reviewed and approved by the responsible Government OPSEC officer, per AFI 10-701, Operations Security. This Plan shall include the Government's critical information, why it needs to be protected, where it is located, who is responsible for it, and how to protect it. For the contractor to effectively comply with OPSEC provisions of the contract, the organization will provide the following guidance: (1) Organization’s Critical Information; (2) Adversaries’ collection threat information as it applies to the organization’s mission and the contract; (3) Operations Security guidance; and (4) Specific OPSEC measures the organization requires (as appropriate).

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

1.4.6.1 Key Control. NOTE: All references to keys include key cards. The contractor shall establish and implement methods of ensuring that no keys/key cards issued by the Government are lost or misplaced or are used by unauthorized persons. No keys issued by the Government shall be duplicated. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas.

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

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

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

1.4.7 Special Qualifications: The contractor shall ensure all employees possess all required licenses for handling protected health information used in the performance of this contract. This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information. (NOTE: The Government does not provide training to contractors. Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified, and otherwise qualified to provide services.)

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

Contractor Maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines and perform annual HIPAA training in order to meet those standards and guidelines

1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract and remain on sight during duty hours. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities. Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed.

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

1.4.11. 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, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.

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

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

1.4.14 Phase In / Phase Out Periods: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the contractor shall have personnel on board, during the 30 days phase in/ phase out periods. During the phase in period, the contractor shall become familiar with performance requirements in order to commence full performance of services on the contract start date.

2.0 Definitions and Acronyms:

2.1 Definitions:

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

2.1.2. Case: a medical package submitted to the respective service with the goal of obtaining a definitive disposition.

2.1.3. Case Error: a failure to process cases in accordance with the DOD, USAF, and/or ANG policies, appropriate directives, established processes, and/or guidance under the direction of the servicing SME as determined by Leadership.

2.1.4. Case Processing Time is defined as a duration of time that begins on the date of the contractor’s receipt of a case and ends on the date of the contractor’s delivery of the medical recommendation and case disposition to the appropriate agency. Time spent with the military provider is not counted against the contractor’s processing time.

2.1.5 Closed Case: a case closed with a definitive disposition or sent to a Higher Authority, including the ARC LOD Board.

2.1.6 Defective Service: A service output that does not meet the standard of performance associated with the PWS.

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

2.1.8. Definitive Disposition: Case where a final decision is reached, includes but not limited to: Approved, Disqualified, Terminated, In the Line of Duty, Not in the Line of Duty, or assigned an Assignment Limitation code.

2.1.9 Higher authority: the final disposition office outside of the direct ANG MCM case processing office supported by the contractor. For purposes of the ANG metrics, a case will be considered a “Closed case” once sent to a Higher Authority or the ARC LOD Board.

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

2.1.11 MILITARY COORDINATION is defined as a case that has been worked by the contract staff but needs to be elevated to the military staff for adjudication. Military coordination is an internal process and not considered Higher Authority as defined in 2.1.9 above and, therefore, these cases are not considered closed for metrics reporting purposes. Once a case is sent to the military to close, the contractor may count them as referred to the military provider and stop counting days unless it is returned to the contractor for action. The contractor shall forward all potential disqualification cases for military coordination if the government requests.

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

2.1.13 Quality Assurance: The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

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

2.1.15 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements.

2.1.16. Returned Without Action: Cases with a request for more information where a definitive disposition is not made.

2.1.17 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:

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

3.1 Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS.

3.1.1 Onsight: desk space, telephones, computers and other items necessary to maintain an office environment. The maintenance and repair costs to any incidental property damage will be the responsibility of the Government. The contractor could be liable for loss if damage is found to be intentional or due to neglect.

3.1.2. Remote: Computers and other items necessary equipment to perform the job. The maintenance and repair costs to any incidental property damage will be the responsibility of the Government. The contractor could be liable for loss if damage is found to be intentional or due to neglect.

3.2 Materials: Onsight: The Government will furnish consumable office supplies such as papers, pens/pencils, and similar products from on hand stock.

3.3 Equipment: Onsight: Desk space, telephones, computers and other items necessary to maintain an office environment

3.4 Services: The Government will provide communication and technology supports for the Government furnished equipment.

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

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

4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

4.2 Secret Facility Clearance: N/A.

4.3 Contractor Security Clearance: The contractor’s employees performing work in support of this contract shall have been granted a SECRET security clearance from the Defense Industry Security Clearance Office.

If a SECRET or TOP SECRET facility clearance is required or contractor employees are required to have a SECRET or TOP SECRET security clearance, a corresponding DD254 must be provided with the procurement package to be attached to the solicitation.

5.0 Requirements: Overall Description of the Task: The contractor shall provide all personnel and any non-Government furnished equipment, tools, materials, supervision, and quality control necessary to perform ANG Medical Case Management Program Services as defined in this PWS. The Government will provide access and systems-based knowledge training for required Government systems. The section(s) to follow delineate the specific requirements. The contractor shall:

5.1. Interact with outside agencies/organization as needed to gather any information required to properly disposition a medical case as defined by the PWS. The agencies include but are not limited to the Air Force Medical Service (AFMS), Aeromedical Consult Service, the Air Force Surgeon General’s Office, Air Force Personnel Center, ANG units, military treatment facilities, recruiters, NGB directorates, and other certification/waiver authorities.

5.2 Develop a standardized written process for guidance on medical cases which are not clearly defined in directives as needed. Initially the contractor may solicit SME guidance or use other methods in developing this guidance document. This document will be reviewed and approved by the COR, and SME or designated Government representative prior to implementation. Further modifications, if any, are also subject to review and approval prior to implementation.

5.3 Provide comprehensive medical case management for internally processing approximately 12,000 to 13,000 closed cases annually resulting in definitive adjudication and supporting the medical readiness of the ANG. The medical recommendations/dispositions made at the NGB/SG level must be reliable, reproducible, defendable, and timely. Medical cases are reviewed for the purpose of ensuring medical readiness for the ANG.

5.4 Provide a medical recommendation for each case submitted IAW applicable guidance.

5.5 Provide written justification for each medical recommendation as directed by applicable policy/guidance.

5.6 Provide personnel and develop a process to answer the field on the status of cases. The expectation is these “Status Checks” shall be completed within three duty days.

5.7 Contractor shall utilize the case processing and tracking system provided by the government to process and track each case submitted to Medical Case Management. The contractor shall submit a report of the tracked cases to the COR on a monthly basis.

5.8 Contractor providers shall have prior work experience in occupational health and/or adult primary care (i.e. family medicine, flight medicine, internal medicine, emergency medicine, or similar). Physicians or Providers are preferred to have prior experience in military flight medicine or medical case management. Graduates of the Aerospace Medicine Primary (AMP) Course and sister service AMP equivalents are preferred. Board-certified Occupational Health doctors may also be considered.

5.9 All contracted personnel must be able to make independent judgment with reference to various references, publications, memorandums, or other documentation to successfully manage medical cases and determine disposition of cases. Limited or no assistance will be provided by the NGB/SG staff.

5.10 Have a Contract Manager and Contract Medical Director (as defined in paragraph 5.12.1) on sight during duty hours.

5.11 Case Types & Performance Requirements. The contractor shall close cases within time goals 90% of the time for each case type. The types of cases include, but are not limited to:

5.11.1 Line of Duty (LOD). LOD case types include appeals, formal, informal, re-investigations, and prior service condition cases. The contractor shall follow the guidelines contained within (but not limited to) the most recent versions of: DODI 1241.01 Reserve Component Line of Duty Determination for Medical and Dental Treatments and Incapacitation Pay Entitlements, DODI 1332.18 Physical Disability Evaluation, AFI 48-133 Duty Limiting Conditions , AFI 36-3212 Physical Evaluation for Retention, Retirement and Separations, AFMAN 41-210 TRICARE Operations and Patient Administration, DAFI 36-2910 Line of Duty Determination, Medical Continuation (MEDCON), and Incapacitation (INCAP) Pay, and DAFMAN 48-123 Medical Examinations and Standards in order to recommend a line of duty finding for each case. Historically, 250 LOD case types were processed monthly and is projected to increase. Contractor processing times for LOD cases will not exceed 30 calendar days (20 calendar days for formal LODs).

5.11.2 Fly Cases. Fly cases include flying physical certification exams, fly waivers, and fly waiver extensions. The contractor shall follow the guidelines contained within (but not limited to) the most recent versions of AFI 10-250 Individual Medical Readiness, DAFMAN 48-123 Medical Examinations and Standards, AFMAN 48-149 Flight and Operational Medicine Program, DODI 6025.19 Individual Medical Readiness, Air Crew Medication List, Air Force Enlisted Classification Directory, Air Force Officer Classification Directory, Initial Fly and Special Operations Physical Examination Matrix, AETC Physical Examination Accomplishment and Recording Spreadsheet, Air Force Waiver Guide, and the Medical Standards Directory (MSD) in order to make a medical recommendation for a flying class certification. Historically, approximately 100 fly cases were processed monthly. Contractor processing times for fly cases will not exceed 14 calendar days.

5.11.3 Retention Cases. Retention cases include Fitness for Duty or Non-Duty DES evaluations, Prior Service Conditions, initial/modified/renewal RILO cases, cases that include both a fly and retention component, and Physical Evaluation Board (PEB) RWOA cases. The contractor shall follow the guidelines contained within (but not limited to) the most recent versions of DAFMAN 48-123 Medical Examinations and Standards, AFMAN 41-210 TRICARE Operations and Patient Administration, AFI 48-133 Duty Limiting Conditions, DAFI 36-2910 Line of Duty (LOD) Determination, Medical Continuation (MEDCON), and Incapacitation (INCAP) Pay, DODI 1332.18 Disability Evaluation System, AFI 36-3212 Physical Evaluation for Retention Retirement and Separation, DODM 1332.18 Volume 1 and Volume 2, Disability Evaluation System Manual; General Information and Legacy Disability Evaluation System Time Standards, DODI 6490.07 Deployment-Limiting Medical Conditions for Service Members and DOD Civilian Employees, DODI 1241.01 Reserve Component LOD Determination for Medical Treatments and INCAP Pay, Air Force Personnel Center/Disability Retirements Branch (AFPC/DPFDD) Disability Operations Branch Air Forced Medical Service (AFMS) Knowledge Exchange, and the Medical Standards Directory in order to make a medical recommendation regarding a member’s fitness for duty. Historically, 240 retention cases were processed monthly. Contractor processing times for retention cases: Fit for Duty/Non-duty DES, modified and renewal RILO cases will not exceed 14 calendar days. Prior Service Condition cases will not exceed 20 calendar days. Per DAFMAN 48-108 Pre-disability Evaluation System, the contractor processing time for IRILOs will not exceed 10 calendar days. Contractor processing times for PEB RWOA cases will not exceed 30 calendar days.

5.11.4 Commissioning physicals for serving members. The contractor shall follow the guidelines contained within (but not limited to) the most recent versions of DODI 6130.03, Vol 1, Medical Standards for Appointment, Enlistment, or Induction in the Military Services, DAFMAN 48-123 Medical Examinations and Standards, and the Air Force Officer Classification Directory in order to make a medical recommendation for commissioning in the ANG. Historically, fewer than 10 commissioning physicals for serving members were processed monthly. The contractor processing times for commissioning physicals for serving members cases will not exceed 14 calendar days.

5.11.5 Incapacitation Pay (INCAP). The contractor shall follow the guidelines contained within (but not limited to) the most recent versions of DAFI 36-2910 Line of Duty Determination, DODI 1241.01 Reserve Component Line of Duty Determination for Medical and Dental Treatments and Incapacitation Pay Entitlements, DODI 1332.18 Physical Disability Evaluation, AFMAN 41-210 TRICARE Operations and Patient Administration, DAFMAN 48-123 Medical Examinations and Standards to make a medical recommendation for INCAP cases. Historically, approximately 10 INCAP cases were processed quarterly. Contractor processing times for INCAP cases will not exceed 14 calendar days.

5.11.6 Medical Hold. The contractor shall follow the guidelines contained within (but not limited to) the most recent versions of DODI 1332.18 Disability Evaluation System, DODM…