PWS Medical Analysis Support Services - 2025.pdf

PERFORMANCE WORK STATEMENT

Department of Defense Education Activity 4800 Mark Center Drive

Alexandria, VA 22350

PERFORMANCE WORK STATEMENT

FOR

Medical Analysis Support Services

1. General Information and Scope of Work.

1.1. Agency. The Department of Defense Education Activity (DoDEA) serves the educational needs of approximately 67,000+ dependents of military and civilian employees by providing pre-kindergarten through twelfth grade (PK-12) instruction in approximately 165 brick-and-mortar schools worldwide. Student enrollment varies based primarily on the deployment of military troops worldwide. In North America, DoDEA operates 50 schools located in seven states, Puerto Rico, and Cuba. In Europe and the Middle East, DoDEA operates 64 schools located in Germany, England, Netherlands, Belgium, Italy, Spain, Turkey, and Bahrain. In the Pacific, DoDEA operates 45 schools located in Korea, Japan (mainland and Okinawa), and Guam.

1.2. Background. DoDEA requires services by medical professionals to evaluate and support requests for reasonable accommodations (RA), the Voluntary Personnel Reassignment (VPR) Program, various leave programs (including, but not limited to, the Voluntary Leave Transfer Program (VLTP), sick leave, leave under the Family Medical Leave Act (FMLA), and advanced sick leave) and related medical issues documentation review, travel accommodations (other than economy/coach seating) (TA), employee and dependent medical travel (EDMT), and emergency medical travel (EMT) from DoDEA employees, to include the medical services reviewer medical professionals to reach out to the treating provider for all cases submitted for review. Recommendations with medical referral(s) information if necessary for both CONUS and OCONUS employees.

1.2.1. Under the Rehabilitation Act of 1973, as amended, and the Americans with Disabilities Act Amendments Act of 2008 (ADAA), DoDEA is required to provide reasonable accommodation (RA) to employees and applicants for employment with known physical or psychological disabilities to ensure they have full access to equal employment opportunity, unless such accommodation would cause an undue hardship to DoDEA. When the disability is not obvious, the Disability Program Manager (DPM) may require medical documentation to make a determination as to whether the requestor has a qualifying disability, whether the requestor needs an RA because of that disability, and what RA(s) would be effective. The medical documentation submitted may include a description of the disability; the nature, severity, and duration of the disability; the activity or activities the disability limits; the extent to which the disability limits the requestor’s ability to perform the activity or activities; the RA needed and/or requested;

and whether the use of a mitigating measure might eliminate the need for a RA. To help ensure an appropriate determination is made, the contractor will assist authorized DoDEA personnel in reviewing the medical documentation submitted.

1.2.2. In accordance with DoDEA policy, employees may submit a request for reassignment based under the VPR Program based upon a medical condition(s), provided the applications provide sufficient information and/or documentation to justify such a request. For consideration due to medical reasons, applications must include supporting medical documents.

1.2.2.1. If a civilian medical practitioner on the economy provides a medical statement, the physician’s statement must be in English or translated to English.

It must indicate the specific medical condition (diagnosis), prognosis, the medical basis for inability to remain in the current location/position, the medical basis for the ability to work at the designated new location/position, and the type of medical care, climate or environment needed to relieve the medical condition.

The statement must also include documentation that the medical condition cannot be treated on the economy in the area where the employee currently works.

1.2.2.2. The contractor will make a recommendation by reviewing the medical documentation submitted by the applicant, identifying if the employee or family member can or cannot be medically treated in the local area, and identifying the locations the employee or family member can be treated.

1.2.3. Under the Employee and Dependent Medical Travel (EDMT) program, employees and their dependents assigned to a foreign permanent duty station (PDS), may be eligible for funded transportation when the local medical facilities (military or civilian) cannot accommodate the medical or dental needs at their assigned foreign PDS. The Authorizing Official (AO) may authorize transportation to the facility closest to the civilian employee’s PDS where suitable health care can be obtained (known as the designated point.

1.2.4. It is Department of Defense (DoD) policy, per the Joint Travel Regulations (JTR) at par. 020206-K, that a travel accommodation may be used for medical or special needs;

however, must be substantiated by a medical authority. Prior to the approval of premium seating, travel options such as economy plus, bulkhead seating that provides extra leg room, or two adjoining coach seats must be considered.

Travel Accommodations requesting premium class seating require written certification to substantiate the medical condition (disability) or special need that necessitates a specific seating accommodation and/or class of service requested. Authority to use upgraded accommodations is limited to the disabled or special needs traveler, and if deemed medically necessary, their attendant. For temporary disability, a medical authority must recertify the traveler’s medical condition after the certification duration expires or otherwise as appropriate. Lifelong disabilities are not required to recertify the disability, however, must recertify if it remits or intensifies.

1.2.5. Various leave programs such as the Voluntary Leave Transfer Program (VLTP), requests to use leave under the Family Medical Leave Act (FMLA), and requests for advanced sick leave require employees to provide administratively acceptable medical documentation, in addition to other absence requests, as stipulated in policy.

1.3. Scope of work. The Contractor shall provide medical expertise to support medical-related services in reviewing, analyzing and assisting authorized DoDEA personnel in determining if the documentation sufficiently supports the requested services.

2. Requirement (Objectives). The objective of this effort is to obtain the expertise of technical and functional medical personnel to support the DoDEA TA program, in accordance with all pertinent laws, regulations, and policies as they relate to the services being provided. The objectives of the PWS are outlined below with the supporting tasks associated with each objective. Each objective is represented as a Contract Line-Item Number (CLIN).

2.1. Medical Document Analysis (Objective 1) [approximately 300 cases/year]. The objective of Medical Document Analysis is to evaluate all medical documentation. This includes assessing the sufficiency of documentation to support requests for reasonable accommodations, transfers, voluntary reassignments, new appointments to overseas positions, various leave programs, medical travel and travel accommodations. Initial response to a typical request will be made in 72 hours, or less, from the date the documents are received from DoDEA. All tasks will be completed within 72 hours, except for tasks requiring further clarification from the patient’s medical professional. Where clarification from the patient’s medical professional is required, those tasks shall be completed in five (5) business days. However, the capability to respond in less time based on urgency must be available. The Contractor shall provide services that include, but are not limited to:

2.1.1. Task 1 – Assisting authorized DoDEA personnel in reviewing the medical documentation submitted for various leave requests and determining if the documentation adequately supports the employee’s request, obtaining clarification from the patient’s physician by email or via telephone when necessary.

2.1.2. Task 2 – Assisting authorized DoDEA personnel in reviewing the medical documentation submitted in RA applications to make a determination regarding whether the requestor has a covered disability, whether the requestor needs a RA because of that disability, and what RA(s) would be effective.

2.1.3. Task 3 – Assisting authorized DoDEA personnel in reviewing medical documentation submitted in travel accommodation requests to make a determination if the documentation adequately supports the employee’s request, recommending appropriate accommodations based on the medical necessity, and obtaining clarification from the traveler’s physician by email, or via telephone when necessary.

2.1.4. Task 4 – Assisting authorized DoDEA personnel in reviewing medical documentation submitted for EDMT requests and, consistent with the requirements in JTR 0331, determining if the documentation adequately supports the employee’s request, if there is a valid urgency for the travel (i.e., consideration of the dates listed in Section 2 of Form 5050.02-F2), the location nearest to the foreign PDS where suitable medical treatment is available and the appropriate amount of time the patient should be permitted to be away from PDS to validate estimate supplied by patient’s primary care doctor.

2.1.5. Task 5 – Assisting authorized DoDEA personnel in reviewing medical documentation submitted for VRP applications to determine if the application and medical documents submitted adequately support the employee’s request, obtaining clarification from the patient’s physician by email or via telephone when necessary.

2.1.6 Performance Standards (PS) and Acceptable Quality Levels (AQL).

The following applies to Objective 1:

PS1 – All tasks completed within the required timeline and error-free.

AQL1 – 100% of all tasks completed by the agreed upon completion date in accordance with applicable policies and procedures.

2.2. Patient Referral (Objective 2) [approximately 150 cases/year]. The Contractor shall assist in the referral of patients to the nearest CONUS or OCONUS location to obtain suitable medical treatment. The Contractor shall provide services that include, but are not limited to:

2.2.1. Task 1 – Identifying if suitable medical treatment is available in the foreign PDS area for the employee or dependent; and if not, identifying the location nearest to the foreign PDS where the employee or dependent can obtain suitable medical treatment.

2.2.1.1 Initial response to a typical request will be made in 72 hours, or less, from the date the documents are received from DoDEA. All tasks will be completed within 72 hours, except for tasks requiring further clarification from the patient’s medical professional. Where clarification from the patient’s medical professional is required, those tasks shall be completed in five (5) business days. However, the capability to respond in less time based on urgency must be available.

2.2.1.2. Providing recommendations on the capacity of surrounding public health systems and the TRICARE Network to determine if medical needs can be reasonably met at the requested OCONUS location.

2.2.1.3. Identifying if suitable treatment options are available at local medical facilities operated by host nation doctors and hospitals.

2.2.1.4. Determining the type of medical care or identify the physical climate and/or environmental conditions (pollution, allergens, etc.) that are needed to relieve the medical symptoms.

2.2.2. Task 2 – Recommending or confirming an appropriate course of action for the patient to receive suitable treatment. Assessing requests for DoDEA-funded medical travel and assisting in locating and referring patients to nearest DoD Military Treatment Facility (MTF) or civilian hospital where suitable treatment is available, to include doctors and hospitals in OCONUS host nations.

2.2.3. Performance Standards (PS) and Acceptable Quality Levels (AQL).

The following applies to Objective 2:

2.3. Patient Transport (Objective 3) [approximately 10 cases/year]. The Contractor shall coordinate employee transportation when required in support of the EDMT program; and provide services that include, but are not limited to:

2.3.1. Task 1 – Providing direct, or consultative, services on each medical travel request referred for review, in accordance with the JTR and other implementing DoD directives.

2.3.1.1 Initial response to a typical request will be made in 72 hours, or less, from within 72 hours, except for tasks requiring further clarification from the patient’s medical professional. Where clarification from the patient’s medical professional is required, those tasks shall be completed in five (5) business days. However, the capability to respond in less time based on urgency must be available.

2.3.1.2. Determining the most appropriate and cost-effective method with which to transport patients needing to be moved, in accordance with regulations.

2.3.1.3. Determining if there is a medical necessity for an attendant or escort for travel and/or if the need for one arises during treatment.

2.3.2. Task 2 – Assisting in coordinating medical evacuation services, if required for patient movement, by coordinating with civilian and/or military travel services.

2.3.3. Performance Standards (PS) and Acceptable Quality Levels (AQL).

The following applies to Objective 3:

2.4. Medical Consultation (Objective 4) [approximately 80 cases/year]. The Contractor shall provide expert advice on complex medical documentation and recommending or confirming the appropriate course of action for the patient to receive suitable treatment at the nearest CONUS and OCONUS medical facility. The Contractor shall provide direct and/or consultative services on leave requests (e.g., sick leave, VLTP, FMLA, advance leave), RA, EDMT, and TA. Assist with patient requests for both CONUS and OCONUS medical facilities. The Contractor shall provide services regarding medical documentation that include, but are not limited to:

2.4.1. Task 1 – The Contractor shall evaluate whether the documented medical services are necessary and appropriate for the patient's condition. Review the physician’s justification for treatments and procedures to ensure they meet medical necessity criteria for the patient.

2.4.1.1 Initial response to a typical request will be made in 72 hours, or less, from within 72 hours, except for tasks requiring further clarification from the patient’s medical professional. Where clarification from the patient’s medical professional is required, those tasks shall be completed in five (5) business days. However, the capability to respond in less time based on urgency must be available.

2.4.1.2 Consults with the patient’s medical professional(s) to determine if the documentation adequately supports the employee’s request (including, but not limited to, leave, RA, TA, EDMT, EMT, VPR), and obtaining clarification from the patient’s medical professional(s) by email or via telephone when necessary.

2.4.2. Performance Standards (PS) and Acceptable Quality Levels (AQL)

The following applies to Objective 4:

2.5. General Requirements [not separately priced].

2.5.1. Invoicing. The Contractor shall submit an invoice monthly for services rendered the previous month using Wide Area WorkFlow (WAWF). Supporting documentation shall include a list of the cases processed during the invoice period, per Contract Line- Item Number (CLIN).

2.5.2. Post-Award Conference. The Contractor shall participate in a post-award virtual conference with DoDEA three (3) business days after the award. This meeting will provide the Contractor an opportunity to discuss contractual requirements, security requirements, and other concerns with the Contracting Officer Representative (COR).

The Government shall prepare and provide a kickoff meeting agenda that will include the following:

Introduction of Personnel

Overview of project tasks Invoice procedures Points of contact Quality Surveillance Process Additional issues of concern

3. Constraints. The following are all the constraints associated with this PWS. Constraints shall be entirely complied with during the entire duration of the contract unless otherwise stated by the Government:

3.1. The Contractor shall perform the services virtually, from the contractor’s facility/call centers to support DoDEA customers in multiple time zones throughout North America (including Puerto Rico and Cuba), Europe, the Middle East, and Pacific regions.

3.1.1. The Contractor must have the capability to send and receive encrypted email or have a secure web portal that supports the delivery and receipt of encrypted documents.

3.1.2. Project Team Leader (PTL). The PTL shall liaise with the Contracting Officer Representative (COR) and be responsible for the performance of the work. The name of this person and an alternate, who shall act for the contractor when the PTL is absent, shall be designated in writing to the DoDEA Contracting Officer (KO) and COR. The PTL or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract.

3.1.3. Qualifications. The Contractor shall provide medical doctors and/or staff with the following qualifications:

Current certifications/licenses as required by their medical, transportation, or support roles within the company;

Proficiency in English and the languages of host nations where DoDEA employees and their dependents are located;

Proficiency with DoD and United States Transportation Command (USTRANSCOM), MEDEVAC, and US Air Force Aeromedical Evacuation (AE) policies and procedures;

Familiarity with the JTR, FMLA, Rehabilitation Act, and the ADAA; and Ability to work with military medical professionals, flight surgeons, and transportation officials to evaluate best course of action to treat and/or move patients.

3.2. Security requirements.

3.2.1. The Contractor and contract employees shall comply with DoDEA Security Management Division (SMD) policies and procedures at all times while working under this contract.

3.2.2. The Contractor shall protect all Personally Identifiable Information (PII), and all information protected under the Health Insurance Portability and Accountability Act (HIPAA) and HIPAA's privacy rules, in physical or electronic form, from public disclosure in accordance with all applicable Federal Law (including the Privacy Act and HIPAA), Federal Policy, Federal Regulations and DoD manuals and Directives. The Contractor shall also strictly follow the Privacy training requirements of FAR 52.224-3.

Additionally, the contractor will provide initial and annual HIPAA privacy rule training along with its annual and initial Privacy training.

3.2.3. Misconduct/Disruption of Services. At any time during the performance of this contract, the KO or COR may request that the Contractor immediately remove any contract employee whose actions result in the clear disruption to the work force or contract performance.

3.3. Response Time. The Contractor shall normally respond to initial requests within 72 hours, unless clarification of from the patient’s medical professional is required. Where clarification from the patient’s medical professional is required, tasks shall be completed in five (5) business days. Capability to respond to emergency situations 24-hours per day, 7-days per week (24/7) (including holidays) must be available.

4. Government-Furnished Resources. Government furnished equipment will not be provided under this contract.

5. Contract Deliverables.

TECHNICAL EXHIBIT 1

DELIVERABLES SCHEDULE

6. Acronyms and Definition. Alphabetical list of definitions of key words used or acronyms.

24/7: 24-hours per day, 7-days per week ADA: Americans with Disabilities Act of 1990 ADAA: ADA Amendments Act of 2008 AE: Aeromedical Evacuation AQL: Acceptable Quality Level

MILESTONE/

DELIVERABLE

FORMAT

# OF

COPIES

PWS

CITE

PLANNED

FREQUENCY

Medical Evaluations, and/or

Recommendations

Written statement signed by licensed

Physician and discussion by phone, as needed

1 2.1

72 hours or less from receiving documents from DoDEA, except for tasks requiring further clarification

Referrals and/or Transport Approach

Email and discussion by phone, as needed

1 2.2

72 hours or less from receiving documents from DoDEA, except for tasks requiring further clarification

Flight Seating Accommodation Recommendation

Email and discussion by phone, as needed 1 2.3

72 hours or less from receiving documents from DoDEA, except for tasks requiring further clarification

Medical Consultation Email and discussion by phone, as needed

1 2.4

As needed, 72 hours or less from receiving documents from

DoDEA, except for task requiring further clarification

Respond to Emergency on a 24/7

Basis

Email and discussion by phone, as needed 1 3.3 Immediately

Invoicing WAWF 1 2.5.1. Monthly

Quality Control Plan Word 1 7.2 45 days after receipt of QASP

AO: Authorizing Official Business Day: Monday through Friday, excluding Federal holidays CLIN: Contract Line-Item Number CONUS: Continental United States COR: Contracting Officer Representative DoD: Department of Defense DoDEA: Department of Defense Education Activity DPM: Disability Program Manager EDMT: Employee and Dependent Medical Travel EEOP: Equal Employment Opportunity Programs EMT: Emergency Medical Travel FMLA: Family Medical Leave Act HIPPA: Health Insurance Portability and Accountability Act JTR: Joint Travel Regulations KO: Contracting Officer LMER: Labor Management and Employee Relations Division MEDEVAC: Medical Evacuation MTF: Military Treatment Facility OCONUS: Outside of Continental United States PII: Personally Identifiable Information PDS: Permanent Duty Station RA: Reasonable Accommodation RESOURCES: Government Furnished items and services SMD: Security Management Division TA: Travel Accommodation USTRANSCOM: United States Transportation Command VLTP: Voluntary Leave Transfer Program VPR: Voluntary Personnel Reassignment

7. Performance Requirement Summary (PRS).

7.1 Performance Requirement Summary (PRS).

Performance Objective

Performance Standard

AQL Inspection Method

Medical Evaluations, Referral, Consultation, and/or Transport Approach, PWS 2.2, 2.3 & 2.4

All tasks completed within the required timeline and error free

100% of all tasks are reviewed and completed by the agreed upon completion date and in accordance with applicable policies and procedures.

Periodic Surveillance through observation and Monthly Status

Reports

Flight Seating Accommodation

Recommendation, PWS 2.2 & 2.3

All tasks completed within the required timeline and error free

100% of all tasks are reviewed and completed by the agreed upon completion date and in accordance with applicable policies and procedures.

Periodic Surveillance through observation and Monthly Status

Reports

Respond to Emergency on a 24/7 Basis, PWS

2.3 & 3.3

All tasks completed within the required timeline and error free

100% of all tasks are reviewed and completed by the agreed upon completion date and in accordance with applicable policies and procedures.

Periodic Surveillance through observation and Monthly Status

Reports

7.2 Quality Assurance Surveillance Plan (QASP).

The Government will utilize a QASP to monitor the contractor’s performance on the contract.

The QASP is a living document and can change at any time during the life of the contract. As such, the Government reserves the right to unilaterally edit the QASP at the Government’s discretion.