HT0011-16-R-0040-01-Global_NAL_RFP-Amendment-12-29-16.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to:

1.Update Performance Work Statement 2.Update Addendum FAR 52.212-1 and 52.212-2 3.Remove FAR Clause 52.219-9 Alt II 4.Update Attachment 3, 5, and 6 5.Change System Integration CLINs description and 6.Add Attachment 13 (Questions and Answ ers)

See highlighted summary of changes for more information.

1. CONTRACT ID CODE PAGE OF PAGES

S 1 75

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 29-Dec-2016

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X HT0011-16-R-0040

X 9B. DATED (SEE ITEM 11)

13-Dec-2016

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

29-Dec-2016

CODE

DHA CONTRACTING OFFICE-FALLS CHURCH

7700 ARLINGTON BLVD

FALLS CHURCH VA 22042

HT0011 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 0009

The CLIN extended description has changed from:

IAW PWS section 5.6

To:

IAW PWS section 5.6.2.

CLIN 1009

IAW PWS section 5.6

CLIN 2009

IAW PWS section 5.6

CLIN 3009

IAW PWS section 5.6

CLIN 4009

IAW PWS section 5.6

The following have been modified:

LIST OF ATTACHMENTS

Attachment Number Document Name Number of Pages 1 Non-Disclosure Agreement 2

2 PII PHI 12

3 Historical Workload (updated 12/29/16) 4 4 Pricing Sheet Spreadsheet 5 Draft QASP (updated 12/29/16) 14 6 Small Business Participation Plan (Updated 12/29/16) 2 7 Nurse Advice Line Beneficiary Satisfaction Survey 3 8 Tricare Policy for Access to Care 9 9 DFARS Checklist 5 10 Contract Data Requirements List(CDRLS) 2 11 Written Determination 1 12 OCI Contract List Spreadsheet 13 Questions and Answers (Added 12/29/16) 23

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (PWS)

Global Nurse Advice Line

PART 1: GENERAL INFORMATION

1 General: This is a non-personal services contract to provide Global Nurse Advice Line (NAL) services. The

Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform Global NAL services as defined in this Performance Work Statement, except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

2 Background:

2.1 Currently, there are two NAL contracts being executed. The CONUS NAL offers MHS eligible beneficiaries located in the United States toll free telephone access to a telehealth registered nurse for triage services, self-care advice, and general health inquiries 24 hours a day, 7 days a week. If necessary, the CONUS NAL also offers civilian network provider locator support and specified Military Treatment Facility (MTF) appointing services for the Military Health System (MHS) beneficiaries, except those enrolled to the US Family Health Plan. Eligible MHS beneficiaries can access the NAL by calling 1-800-TRICARE (1-800-874-2273). The second NAL contract is the OCONUS NAL, which provides 24 hours a day, 7 days a week NAL services to MHS beneficiaries in Europe, Africa, and the Middle East.

2.2 The MHS implemented the NAL in order to achieve the following goals:

i. Direct patients to the most clinically appropriate level of care.

ii. Enhance access to care, especially after hours and when the beneficiaries are traveling.

iii. Reduce unnecessary emergency department and urgent care utilization.

iv. Capture MTF enrolled beneficiary care back to the direct care system in order to reduce purchased care costs.

v. Improve the patient’s continuous healthcare relationship with his/her MTF or civilian healthcare team and

Primary Care Manager (PCM).

vi. Maximize patient satisfaction.

2.3 The MHS leadership and the Services have requested a Global NAL to cover eligible MHS beneficiaries enrolled to both CONUS and OCONUS MTFs (TRICARE Prime and Plus) and TRICARE Prime beneficiaries enrolled to CONUS Managed Care Support Contractors. TRICARE Overseas Program Prime Remote, TRICARE Standard, TRICARE For Life, TRICARE Reserve Select, TRICARE Retired Reserve, and TRICARE Young Adult beneficiaries are only eligible to use the Global NAL when they are traveling or physically residing in the United States. Those beneficiaries enrolled to the US Family Health Plan (USFHP) are not eligible to use the Global NAL.

3 Objectives:

3.1 The Global NAL services aim to achieve the same set of goals, as articulated in paragraph 2.2.

3.2 The contractor shall provide reliable, timely, professional, and courteous nurse triage, care advice, care coordination, and customer service, 24 hours a day, 7 days a week to eligible MHS beneficiaries, as described in this PWS in order to improve healthcare and lower costs.

3.3 The contractor’s telehealth qualified registered nurses (RNs) shall provide all eligible MHS beneficiaries with clinical advice based on the United States of America nationally recognized telehealth nursing standards, protocols or guidelines, coupled with the RNs professional experiences and judgement to ensure MHS beneficiaries receive high quality nurse triage services.

3.4 The contractor shall work with the MTFs to provide appointing services 24 hours a day 7 days a week for 24

HRS appointment types (when appropriate based on call disposition and eligibility) and submit referrals for TRICARE authorized civilian urgent care clinics in CHCS, the new electronic health record, MHS Genesis, or another specified system for MTF enrolled beneficiaries, if applicable in order to capture care back to the direct care system and improve access to care.

3.5 The contractor shall offer post-telehealth RN triage provider network / MTF locator services and contact information assistance for urgent and emergent triage end points and otherwise, as needed to provide timely and reliable care coordination and maximize beneficiary satisfaction.

3.6 The contractor shall comply with MHS directives, Defense Health Agency (DHA), and Department of Defense (DOD) polices as written, when applicable to the NAL services they provide in order to ensure Global NAL systems and processes conform to the appropriate standards and requirements.

3.7 The contractor shall work together with the NAL program management office (PMO) to ensure the triage-based determinations for advising patients in pursuing an appropriate level of care (triage end points) are consistent with the current standards of care and MHS goals / standards for assigning patients to emergency care, urgent care, MTF-based care, and self-care.

3.8 The MHS shall work with the contractor to implement the Global NAL according to the specifications listed within this document. In support of implementation, the MHS shall provide the contract awardee with access to the appropriate government systems, subject to terms of required non-disclosure agreements, data use agreements, and organization conflict of interest filings.

3.9 All Global NAL products of this contract shall reflect generally accepted private sector business practices and applicable Department of Defense policies and regulations.

4 Scope:

4.1 The Global NAL services include:

i. Continuous telehealth registered nurse triage based on evidence based guidelines, algorithms or protocols to direct patients to the most clinically appropriate level of care including self-care, urgent care, and emergent care.

ii. Specified MTF appointing services,

iii. Customized MTF transfers to support the MTF’s capabilities,

iv. Civilian TRICARE authorized urgent care referral services,

v. Civilian network provider and MTF locator support services, and

vi. Customer service.

4.2 The Global NAL service shall be offered 24 hours a day, 7 days a week for all eligible MHS beneficiaries. The below chart shows the MHS beneficiaries by TRICARE Health Plan, which are eligible to receive Global NAL Services.

TRICARE Health Plans Global NAL Excluded

TRICARE Prime X TRICARE Plus X TRICARE Prime Remote X TRICARE Prime Overseas X TRICARE Prime Remote Overseas X* TRICARE Standard and Extra X TRICARE Standard Overseas X* TRICARE For Life X* TRICARE Reserve Select X* TRICARE Retired Reserve X* TRICARE Young Adult X* US Family Health Plan X

*These beneficiaries are only eligible if they are traveling or physically residing in the United States.

4.3 Services shall include customized internal processes to direct callers based on their beneficiary status (Active

Duty, Active Duty Family Member, Retiree, and Retiree Family Member) and TRICARE health plan. More information on TRICARE health plans can be found at: http://www.tricare.mil/Plans/HealthPlans.aspx.

4.4 Other capabilities include the ability to provide real time information sharing, business intelligence, reporting, and archiving of documented call encounters at a corporate, regional, and local level and interoperability with existing military applications and systems to include the Defense Enrollment Eligibility Reporting System (DEERS), Composite Health Care System (CHCS), and the new military electronic health record called MHS Genesis. Interoperability includes: 1) Using DEERS to verify caller eligibility to use the service, 2) Accessing multiple CHCS hosts to make appointments with callers’ Primary Care Manager, Primary Care Team, or Primary Care Clinic or submitting TRICARE authorized urgent care referrals, and documenting caller information, triage notes, 3) booking appointments and submitting TRICARE authorized urgent care referrals in the new MHS Genesis.

4.5 Eligible MHS beneficiaries shall access the NAL, if they are physically located within the United States, by calling 1-800-TRICARE (1-800-874-2273), option 1. Once the MHS beneficiary selects option #1, the call will be transferred to the contractor’s supplied telephone number. Services shall include toll free telephone phone numbers for the international countries listed below, or any other country with an established MTF.

i. Italy

ii. United Kingdom

iii. Germany

iv. Turkey

v. Belgium

vi. Bahrain

vii. Spain

viii. Greece

ix. Cuba

x. Puerto Rico

xi. Japan

xii. South Korea

xiii. Guam

4.6 Period of Performance: The period of performance shall be for one (1) Base Period of 12 months, which includes an implementation period and four (4) 12-month option years. The Period of Performance reads as follows:

Base Year Option Year I Option Year II Option Year III Option Year IV

5 General Information

5.1 Quality Control:

5.1.1 The contractor shall develop and maintain an effective quality control program 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 quality control program is the means by which he/she assures himself/herself that the work complies with the requirement of the contract.

5.1.2 The contractor shall prepare and adhere to a Quality Control Plan (QCP), which will be submitted with the contractor’s proposal (Deliverable 12). The QCP shall document how the contractor shall meet and comply with the NAL personnel certification and experience requirements and other quality standards established in this performance work statement. At a minimum, the QCP must include a self-inspection plan, an internal staffing plan, a call encounter review plan, and an outline of the procedures that the contractor shall use to maintain quality, timeliness, responsiveness, customer satisfaction, and any other requirements set forth in this solicitation. The QCP shall provide the quality standards the contractor will use to ensure optimum beneficiary and government service and satisfaction. The self-inspection plan shall include how the contractor will communicate problems/issues and their appropriate resolutions to the government.

5.1.3 A key aspect of the QCP shall be the nursing triage guidelines, algorithms, or protocols utilized for NAL services. The triage algorithms, guidelines or protocols shall have medical review, updates and approval at least annually. These reviews, updates, and approvals shall be performed by both the contractor and the government. As part of the QCP, the contractor shall provide the top five adult and top five pediatric triage guidelines, algorithms, or protocols expected to be utilized for this service.

5.1.4 The QCP shall demonstrate areas where the QCP can be modified and customized for the government. A comprehensive written QCP shall be submitted to the contracting officer and contracting officer representative (COR) with the contractor’s proposal, within 5 days after contract award, and within 5 working days when changes are made thereafter. After acceptance of the QCP the contractor shall receive the contracting officer’s acceptance in writing of any proposed change to the QC system.

5.2 Quality Assurance:

5.2.1 The government shall evaluate the contractor’s performance under this contract in accordance with the

Quality Assurance Surveillance Plan (QASP) (Deliverable 2). This plan is primarily focused on what the government must 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 the minimum acceptable defect rate(s).

5.2.2 The QASP provides the COR with a proactive way to avoid unacceptable or deficient performance, and provides verifiable input for the required Past Performance Information Assessments. The QASP shall be finalized within 5 days following award and a copy provided to the Contractor after award. The QASP is a living document and may be updated by the government as necessary. In the event that the QASP needs updating, the government shall provide written notification to the contractor. Both parties shall mutually agree on a timeframe for the update and the implementation of the new and/or changed areas of the plan.

5.3 Recognized Holidays: The Global NAL shall operate 24 hours a day, 7 days a week requiring the contractor to provide continuous services, as described in this PWS.

5.4 Hours of Operation: The contractor is responsible for conducting business, 24 hours a day, 7 days a week and shall maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS, at all times. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the workforce are essential.

5.5 Place of Performance: The work to be performed under this contract shall be performed at contractor facilities, either in call center(s) or at remote work station(s).

5.6 Type of Contract: The government will award a firm fixed price contract with optional cost line item numbers (CLINs) to give the government flexibility in adding on additional services as required with the approval of funding.

5.7 Security Requirements: Contractor personnel performing work under this contract must be able to obtain common access cards (CACs) or provide a certificate of authentication to gain access to government systems prior to the start of the period of performance base year, and must maintain the level of security required for the life of the contract. The contractor shall have a facility security officer (FSO). The contractor FSO shall:

5.7.1 Identify contractor support personnel who require a CAC for accessing DoD networks, systems, and facilities.

5.7.2 Verify the applicant’s background investigation (Position of Trust) by submitting a request to Procurement Support Branch (PSB).

5.7.3 Complete Sections I and III of the Defense Health Agency (DHA) Form 33, for the initial and/or renewal

CAC.

5.7.4 Submit the form (DHA Form 33) to the COR for approval.

5.7.5 Fax the completed form to (703-681-5207) ATTN: PSB/-TASS/Common Access Card Branch (CACB) or e-mail to (Dha.ncr.security.mbx.personnel-security-tass@mail.mil).

5.7.6 Establish out-processing procedures to collect the CAC when an employee quits, is terminated from the company, or when the CAC is no longer required.

5.7.7 The contractor shall procure, install, and maintain desktop level CAC readers and middleware. The middleware software must run on the desktop and cannot be run from the LAN. The contractor FSO shall ensure that CACs are only used by the individual to whom the CAC was issued. Individuals must protect their PIN and not allow it to be discovered or allow the use of their CAC by anyone other than him/herself.

The contractor shall ensure access to DoD systems applications and data is only provided to individuals who have been issued a CAC and whose CAC has been validated by the desktop middleware, including use of a card reader. Sharing of CACs, PINs, and other access codes is expressly prohibited.

5.7.8 If the contractor chooses to use a cloud service provider or cloud service offering (CSP/CSO), the CSP/CSO must be Federal Risk and Authorization Management Program (FedRAMP) DoD Impact Level 4 certified. The contractor shall provide a security assessment report upon contract award and annually thereafter (Deliverable 15).

5.8 Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use.

5.9 Key Control: The contractor shall follow the key management control under the Organization Best Business

Practices list in the National Institute of Standards and Technology Special Publication 800-53. The contractor shall provide a copy of their security assessment report (SAR) for key control.

5.10 Reserved

5.11 Special Qualifications: The NAL contractor must provide a pool of qualified and state licensed telehealth

RNs. Telehealth RNs must be licensed to provide healthcare advice to beneficiaries within specific states. The telehealth RN must be licensed in the state in which the beneficiary is located at the time of the call for eligible beneficiaries calling within the United States. For eligible MHS beneficiaries calling from outside the United States the telehealth RN may be licensed in any US state. All telehealth RNs shall have at least three years of clinical experience. In order for telehealth RNs to be considered specialized for skill based routing of calls for pediatrics, mental health, or obstetric, they must have either a certification or at least three years of clinical experience in that specialized area.

5.12 Post Award Conference/Periodic Progress Meetings: The Contractor shall attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

5.13 Contracting Officer Representative (COR): The (COR) will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract:

perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications; monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

6 Key Personnel: The personnel listed below are considered essential to the work being performed hereunder.

Prior to substituting, removing, replacing, or diverting any of the specified individuals, the Contractor shall notify the Contracting Officer 15 working days in advance and shall submit a written request and justification (including proposed substitutions) in sufficient detail to permit evaluation of the impact on this Contract. The proposed substitution of personnel must meet or exceed the education, experience, and other technical requirements of the personnel being replaced. No change in personnel shall be made by the Contractor without the prior written consent of the Contracting Officer. However, in urgent situations, as determined or agreed to by the Contracting Officer, an oral request to substitute key personnel may be approved and subsequently ratified by the Contracting Officer in writing. Such ratification shall constitute the consent of the Contracting Officer required by this paragraph. The Contracting Officer will notify the Contractor within 10 working days after receipt of all required information of the decision on the substitution(s). In the event the proposed substitution of key personnel does not meet or exceed the education, experience, and other technical requirements of the personnel being replaced, the Government reserves the right to require continued performance of previously approved key personnel or to require substitution of acceptable replacements for the individuals specified below. The key personnel listed below may, with the consent of the contracting parties, be amended from time to time during the course of the Contract to either add or delete personnel as appropriate.

Position/Labor Category

Education Minimum Requirements

Sr. Program Manager – Global Nurse Advice Line

Bachelor’s degree required A minimum of 18 years progressive project and/or program management experience to include managing a health care call center or nurse triage program. Must have served in supervisory positions and show examples of how the individual has applied strong leadership, interpersonal, organizational, and communication skills in implementing programs and projects. Demonstrate experience managing and implementing programs, including identifying, maintaining, and/or adjusting the resources; overseeing the formal planning, tracking, and reporting of program performance.

Contracts Manager Bachelor’s Degree or equivalent government or private-sector work experience

A minimum of six years contract management experience required.

Program Manager – Telehealth Registered Nurse

(RN)

Bachelor’s in Nursing from an accredited school of nursing.

Must have current licensure as a Registered Nurse. A minimum of 15 years’ experience including 5 years of nursing leadership / supervisory role(s)\. Call center experience is required. Show examples of how the individual applied strong communication, program management and customer service skills in past positions.

Program Manager – Quality Assurance

(QA)

Bachelor’s Degree required.

Clinical background required; a minimum of 3 years of experience managing a quality assurance program. Show examples of how the individual has applied interpersonal, analytical, organizational, and communication skills in managing a QA program. Demonstrate knowledge of quality assurance best practices.

Program Manager – Call Center

Bachelor’s Degree or equivalent government or private-sector work experience

Experience managing multiple call centers.

Demonstrate knowledge of URAC Health Call Center Standards, experience in customer service, performance evaluation, and process improvement. Demonstrate strong interpersonal and communication skills. Demonstrate experience in large volume staff training and coaching.

Security / Information Technology Manager

Bachelor’s Degree or equivalent government or private-sector work experience

A minimum of 5 years of experience with government or private-sector related information technology, cybersecurity, and/or system integration projects.

Specialized experience providing oversight of projects to ensure that developed solutions meet customer requirements. Demonstrate experience in implementing appropriate security measures for IT systems.

Demonstrate experience in identifying security risks; and recommending solutions to optimize IT and/or cybersecurity initiatives.

6.1 The contractor shall provide a senior program manager, contract manager, telehealth RN manager, quality assurance manager, call center manager, and security / information technology manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between 8:00a.m. to 4:30 p.m.

EST, Monday thru Friday except Federal holidays or when the government facility is closed for administrative reasons.

6.2 The contractor shall provide a program management plan (Deliverable 1) describing its approach to maintaining, for the life of the contract, qualified, experienced personnel. The program management plan shall also include sustainment milestones, tasks, and timelines, as well as the management approach regarding their subcontractors. The contractor’s subcontract expenditures (Deliverable 9) shall also be provided on a monthly basis.

7 Identification of Contractor Employees: All contract 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 in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

8 Contractor Travel: The contractor may be required to travel during the performance of this contract to attend working meetings and to conduct quality assurance site visits. The contractor will 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 Government approval/authorization and notification to the COR.

Period of performance travel shall not exceed $15,000.

9 Other Direct Costs: Reserved

10 Data Rights: The Government has unlimited rights to all documents, material, and data produced under this contract. All documents, data, 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, data, and materials may not be used or sold by the contractor without written permission from the Contracting Officer. 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.

10.1.1 Rights to Documents and Other Materials: All documents and materials developed or produced under this contract – regardless of whether such documents and materials are identified as deliverables under the contract – shall be the sole property of the Government. The contractor may not use such documents and materials for any non-Governmental purpose without the advance written permission of the Contracting Officer or the Contracting Officer’s Representative.

11 Reserved

12 Phase In / Phase Out Period:

12.1 The contractor shall reach full operating capability within six months after contract award. The implementation period includes any necessary pilots, tests, or soft launches necessary to ensure a successful deployment. To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the contractor shall have personnel on board, during the six month phase in period. During the phase in period, the contractor shall become familiar with performance requirements in order to commence full performance of services within six months after contract award. The contractor shall produce an incoming operational transition plan identifying the approach to be fully operational within six months of contract award (Deliverable 10).

12.2 During the phase out period the Contractor shall maintain staffing and services to prevent possible negative impact on services. During the phase out period the telephone numbers shall be transferable at the needs of the Government; at the completion of the contract; and at no additional charge to the Government. The contractor shall provide an outgoing transition plan 90 days prior to contract expiration (Deliverable 11). This transition may be to a Government entity, another Contractor or to the incumbent contractor under a new contract/order.

In accordance with the Government-approved plan, the Contractor shall assist the Government in planning and implementing a complete transition from this Contract and/or orders issued under this Contract to a successful provider. This shall include formal coordination with Government staff and successor staff and management. It shall also include delivery of copies of existing policies and procedures, and delivery of required metrics and statistics. This transition plan shall include, but is not limited to:

Coordination with Government representatives, Review, evaluation and transition of current support services, Transition of historic data to new contractor system, Government-approved training and certification process, Transfer of hardware warranties and software licenses (if applicable), Transfer of all necessary business and technical documentation, Transfer of compiled and uncompiled source code, to include all versions, maintenance updates and patches for all software developed to support this contract, Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes, Disposition of Contractor purchased Government owned assets, including facilities, equipment, furniture, phone lines, computer equipment, etc.

Applicable DHA debriefing and personnel out-processing procedures.

Turn-in of all government keys, ID/access cards, and security codes.

Data shall be delivered in Microsoft SQL Server format along with Unified Modeling Language (UML) diagrams .

PART 2: DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.2. 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.

2.3. CONTRACTING OFFICER. 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.

2.4. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. 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 that 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.

2.5. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.6. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.7. 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 Key Personnel listed in 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.

2.8. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.9. QUALITY ASSURANCE. The government procedures to verify that services being performed by the

Contractor are performed according to acceptable standards.

2.10. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.11. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

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

2.13. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.14. WORK WEEK. Monday through Friday, unless specified otherwise.

2.15. MILITARY HEALTH SYSTEM BENEFICIARY. Any individual who is eligible to receive health care services from the Military Health System. The categories of MHS beneficiaries shall be broadly interpreted unless otherwise specifically restricted. (For example: Authorized parents and parents-in-law are not eligible for TRICARE purchased care, but may receive treatment in an MTF (on a space available basis) and may access the Global NAL.

2.16. ELIGIBLE MHS BENEFICIARIES: Individuals enrolled in Defense Enrollment Eligibility Reporting

System (DEERS) described in paragraph 2.3 and 5.2.13

2.17. MILITARY TREATMENT FACILITY. A U.S. Military medical facility treating MHS beneficiaries ranging in size from large hospitals to small clinics.

2.18. UTILIZATION REVIEW ACCREDITATION COMMISSION (URAC). A non-profit charitable organization founded in 1990 to establish standards for the managed care industry. URAC’s broad-based membership includes representation from all the constituencies affected by managed care ─ employers, consumers, regulators, health care providers, and the worker’s compensation and managed care industries.

Member organizations of URAC participate in the development of standards, and are eligible to sit on the Board of Directors. http://www.urac.org/

ACRONYMS:

ACOR Alternate Contracting Officer's Representative CFR Code of Federal Regulations CHCS Composite Health Care System CONUS Continental United States (defined as the 50 United States (U.S.) and the District of Columbia) CO Contracting Officer COR Contracting Officer Representative COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf DD254 Department of Defense Contract Security Requirement List DEERS Defense Enrollment Eligibility Reporting System DFARS Defense Federal Acquisition Regulation Supplement

DHA Defense Health Agency DMDC Defense Manpower Data Center DMIS ID Defense Medical Information System (DMIS) Identifier (ID) DOD Department of Defense ED Emergency Department eMSM enhanced Multi Service Market FAR Federal Acquisition Regulation HIPAA Health Insurance Portability and Accountability Act of 1996 MCSC Managed Care Support Contractor MHS Military Health System MTF Military Treatment Facility NAL Nurse Advice Line OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs PCM Primary Care Manager PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program RN Registered Nurse TE Technical Exhibit UC Urgent Care UCC Urgent Care Clinic URAC Utilization Review Accreditation Commission

PART 3: GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: The Government will provide the Global NAL toll free telephone number, 1-800-TRICARE (874-2273). The Government shall also provide customized MTF instructions for care coordination, which will be updated on a regular basis. Customized MTF instructions will include, but not limited to the hours of operation, telephone numbers, and specific appointing procedures for MTF primary care and urgent care clinics.

3.2. Facilities: Reserved.

3.3. Utilities: Reserved.

3.4. Equipment: Reserved.

3.5. Materials: Reserved.

3.6. Government Information: See Performance Work Statement section 7.1 Compliance documents.

PART 4: CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1. General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS, including national and international telephone lines and international numbers, to perform the task of a continual Global NAL and an established robust network of licensed, specialized registered and experienced nurses for all MHS eligible beneficiaries.

4.2. The Contractor shall also be responsible for updating the call encounter data monthly with the updated

Defense Medical Information System (DMIS) Identifier (ID) table, which is found at:

http://health.mil/Military-Health-Topics/Technology/Support-Areas/Geographic-Reference- Information/DMIS-ID-Tables.

PART 5: SPECIFIC TASKS

5. Task

5.1. Basic Services.

5.1.1. The contractor shall provide nurse triage and care advice, as well as appointing and care coordination services, as outlined below, for all eligible MHS beneficiaries. The contractor shall provide customer service to all callers.

5.1.2. The contractor shall operate with the goal of single-call resolution for all beneficiary health advice, appointing and scheduling support. All eligible beneficiary calls shall be serviced immediately with minimal handoffs between staff and call backs to the beneficiary.

5.1.3. The contractor shall provide services in compliance with current URAC Health Call Center standards as well as maintain URAC’s Health Call Center accreditation for the duration of the contract - https://www.urac.org/accreditation-and-measurement/accreditation-programs/all-programs/health-call-center/.

5.1.4. The contractor’s Global NAL call documentation must be clear, consistent, and sufficient, with respect to caller's pre-intent, telehealth registered nurse endpoint, and final disposition.

5.1.5. The contractor shall provide a Board Certified Physician with current clinical practice of a minimum three to five years post residency experience in family medicine, internal medicine or emergency medicine available 24 hours a day, 7 days a week on-call to support and provide consultation to the telehealth RNs, as required.

5.1.6. The contractor shall offer multiple modalities to access Nurse Advice Line services, as well as transfer callers to MTFs, such as through the telephone, through a mobile application, web-chat, and/or video conferencing.

5.1.7. The contractor shall maintain an Average Speed of Answer (ASA) within a 30 second standard at the beginning of the call and at all exchange points (e.g. a call transfer during the call). The performance standard is an ASA within 30 seconds 95 percent of the reporting period. The ASA is defined as the average delay in seconds that telephone call encounters waiting in the telephone queue of a call center or the delay in seconds during a call transfer between staff before being answered by a live person.

5.1.8. The contractor shall provide a sufficient number of staff at all call stages to maintain the ASA within 30 seconds and prevent eligible MHS beneficiaries being placed on hold.

5.1.9. The contractor shall provide sufficient number of telephone lines into the system to prevent busy signals. Less than 1% of the calls will have a busy signal as indicated in the telephone records.

5.1.10. The contractor shall maintain an abandonment / drop rate of less than 5%, where abandonment is defined as: Calls which drop after 30 seconds before reaching an individual who would have answered the call, or calls that reach the initial stage with the customer service representative, but disconnect prior to completing nurse-triage, and calls which reach nurse triage, but disconnect prior to completing the care coordination process.

5.1.11. The contractor shall electronically record, both written documentation and oral communication

(digital audio recording) between all parties for the entire duration of each call, for 100% of the NAL call encounters, 99.8% of the time. All recordings must be maintained in readable, secure, and assessable format for the lifecycle (retention) of the records. Audio and text electronic records must be in a preferred format for archiving. Preferred formats and archival requirements for permanent electronic records can be found at: http://www.archives.gov/records-mgmt/policy/transfer-guidance-tables.html. The retention period for both audio and text electronic records are the audio recording must be available for a minimum of 2 years and the text documentation must be available and maintained for the duration of the contract.

5.1.12. The contractor shall maintain a secure data repository and business intelligence reporting capability for real time (RT) sharing between / within the contractor’s personnel and government personnel. The system must have the ability to flag or highlight specific types of calls to easily identify trends and alert the government to take action, e.g. crisis calls, epidemics, caller complaints, and disconnected calls.

5.1.13. The contractor shall provide 24 sessions of NAL sustainment training on a yearly basis to the government. This training will be interactive and conducted online and/or over the phone. Training will be adjusted as the program develops. It will include the current state of the NAL, the specific NAL process for handling NAL calls and documenting NAL encounters, services offered and services not covered, and a tutorial on how to navigate the real time database, how to pull custom and canned reports, export data, and other functionality. The contractor shall develop a NAL sustainment training plan after contract award (Deliverable 13).

5.1.14. The contractor is responsible for appropriately training their personnel on all of the processes and systems required to perform the Global NAL mission.

5.1.15. The contractor shall achieve and maintain a 95% beneficiary satisfaction rate. Beneficiary satisfaction shall be measured by both the contractor and the government and evaluated by a mutual agreed upon process with no less than a quarterly review.

5.1.16. The contractor shall provide a monthly progress report (Deliverable 8) summarizing the analysis of the business intelligence reports (Deliverable 14), as well as the status of any tasks and/or major milestones for outstanding projects or process improvement initiatives.

5.1.17. The contractor shall provide customer service, telehealth RN triage, and care coordination services in English and Spanish and have on-demand access to interpreter services for other languages as needed. The prioritized list of languages are:

1. Japanese

2. German

3. Filipino (Philippines)

4. Korean

5. Italian

6. Chamorro (Guam)

7. Arabic

8. Turkish

9. Dutch

10. French

11. Greek

5.1.18. The contractor shall provide the appropriate country based contact phone number for any beneficiary who calls the NAL while travelling in a country not covered by the NAL (a country that does not have an MTF) or is located in a remote OCONUS environment by utilizing this website:

http://www.tricare-overseas.com/ContactUs/.

5.1.19 The contractor is responsible for obtaining and documenting the beneficiary’s consent to provide

PHI and PII to the NAL contracting staff either through the telephone, secure web-chat or video conferencing communication channels prior to the connection. The NAL contractor is also responsible for obtaining and documenting consent to email or text message the MHS eligible beneficiary directly their general self-care and/or watch out conditions.

5.1.20 The contractor must establish a secure mobile friendly website (https secure socket) and/or application in order to offer web-chat, video conferencing, and general health information to assist with self-care.

5.1.21 The contractor shall establish connectivity to the Government information systems (CHCS and MHS Genesis) used for appointing and urgent care referrals through either an MHS sponsored business-to-business gateway, the MHS-sponsored Application Virtualization and Hosting Environment (AVHE), and/or through Citrix 4.1 or higher.

5.1.22 Reserved

5.1.23 The contractor shall build a system to system interface that would query DEERS for every NAL call. The data received from DEERS shall automatically populate and be saved in the NAL Contractor’s real time database. Also see, the Eligibility Verification section.

5.1.24 The contractor shall maintain access with the legacy MHS scheduling and order-entry system, CHCS, and the new electronic health record, MHS Genesis in order to sustain the ability to perform real-time MTF appointing services and submit network urgent care referrals for MTF enrolled beneficiaries.

5.1.25 As MHS Genesis is implemented throughout the MHS the contractor shall maintain the NAL call encounter data in the electronically recorded real time database.

5.2. Eligibility Verification.

5.2.1. The contractor shall verify the eligibility of all Global NAL callers through the Defense Enrollment Eligibility Reporting System (DEERS) in accordance with TRICARE Systems Manual 7950.3-M, April 2015. The contractor shall build a system to system interface that would query DEERS and save the data received into the contractor’s system within six months after contract award. DEERS is the system of record for eligibility; the contractor shall always make eligibility determinations based on what is returned in Defense Manpower Data Center’s (DMDC's) web and system to system interfaces. The contractor shall use the General Inquiry of DEERS (GIQD) system until the automated integrated system is fully operational.

5.2.2. The contractor shall verify eligibility for each beneficiary as directed by the government using government systems, for example using their first and last name, date of birth, and either their DOD Benefit Number (DBN) (11 digit number printed on the back of their military ID card), or, less optimally, their…