HT0011-16-R-0040-02-Global_NAL_RFP-Conformed-1-5-17.pdf

HT0011-16-R-0040

SEE ADDENDUM

(No Collect Calls)

HT0011-16-R-0040 13-Dec-2016

b. TELEPHONE NUMBER 8. OFFER DUE DATE/LOCAL TIME

12:00 PM 17 Jan 2017

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

HT00119. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

DEFENSE HEALTH AGENCY-COD FC

7700 ARLINGTON BLVD

FALLS CHURCH VA 22042

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE 16. ADMINISTERED BY

SEE SCHEDULE

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

FAX:

TEL: 703-681-1143 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$15,000,000

NAICS:

541990

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF116

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 6 Months Program Management and Quality Assurance

FFP

IAW PWS Section 5.14 FOB: Destination

NET AMT

0002 6 Months Eligibility Verification

FFP

IAW PWS section 5.2

0003 6 Months Telehealth Triage Nurse

FFP

IAW PWS section 5.3

0004 6 Months Care Coordination

FFP

IAW PWS section 5.4

0005 Months System Integration (Optional CLIN)

CPFF

IAW PWS section 5.10. (This CLIN will be negotiated and priced after contract award if needed.)

ESTIMATED COST

FIXED FEE

TOTAL EST COST + FEE

0006 6 Months Telecommunications

FFP

IAW PWS section 5.11

0007 6 Months Real Time Database Management

FFP

IAW PWS section 5.12

0008 6 Months Business Intelligence/Report Management

FFP

IAW PWS section 5.13 and 5.15

0009 6 Months PCM On-Call (Optional)

FFP

IAW PWS section 5.6.2

0010 Months Travel

COST

IAW PWS section 8

0011 6 Months Implementation Period - Transition In

FFP

IAW PWS section 12.1

1001 12 Months OPTION Program Management and Quality Assurance

FFP

1002 12 Months OPTION Eligibility Verification

FFP

1003 12 Months OPTION Telehealth Triage Nurse

FFP

1004 12 Months OPTION Care Coordination

FFP

1005 Months OPTION System Integration (Optional CLIN)

CPFF

IAW PWS section 5.10. (This CLIN will be negotiated and priced after contract

1006 12 Months OPTION Telecommunications

FFP

1007 12 Months OPTION Real Time Database Management

FFP

1008 12 Months OPTION Business Intelligence/Report Management

FFP

1009 12 Months OPTION PCM On-Call (Optional)

FFP

1010 Months OPTION Travel

COST

2001 12 Months OPTION Program Management and Quality Assurance

FFP

2002 12 Months OPTION Eligibility Verification

FFP

2003 12 Months OPTION Telehealth Triage Nurse

FFP

2004 12 Months OPTION Care Coordination

FFP

2005 Months OPTION System Integration (Optional CLIN)

CPFF

IAW PWS section 5.10. (This CLIN will be negotiated and priced after contract

2006 12 Months OPTION Telecommunications

FFP

2007 12 Months OPTION Real Time Database Management

FFP

2008 12 Months OPTION Business Intelligence/Report Management

FFP

2009 12 Months OPTION PCM On-Call (Optional)

FFP

2010 Months OPTION Travel

COST

3001 12 Months OPTION Program Management and Quality Assurance

FFP

3002 12 Months OPTION Eligibility Verification

FFP

3003 12 Months OPTION Telehealth Triage Nurse

FFP

3004 12 Months OPTION Care Coordination

FFP

3005 Months OPTION System Integration (Optional CLIN)

CPFF

IAW PWS section 5.10. (This CLIN will be negotiated and priced after contract

3006 12 Months OPTION Telecommunications

FFP

3007 12 Months OPTION Real Time Database Management

FFP

3008 12 Months OPTION Business Intelligence/Report Management

FFP

3009 12 Months OPTION PCM On-Call (Optional)

FFP

3010 Months OPTION Travel

COST

4001 12 Months OPTION Program Management and Quality Assurance

FFP

4002 12 Months OPTION Eligibility Verification

FFP

4003 12 Months OPTION Telehealth Triage Nurse

FFP

4004 12 Months OPTION Care Coordination

FFP

4005 Months OPTION System Integration (Optional CLIN)

CPFF

IAW PWS section 5.10. (This CLIN will be negotiated and priced after contract

4006 12 Months OPTION Telecommunications

FFP

4007 12 Months OPTION Real Time Database Management

FFP

4008 12 Months OPTION Business Intelligence/Report Management

FFP

4009 12 Months OPTION PCM On-Call (Optional)

FFP

4010 Months OPTION Travel

COST

4011 3 Months OPTION Transition Out Period

FFP

IAW PWS section 12.2

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A N/A N/A Government 0002 N/A N/A N/A Government 0003 N/A N/A N/A Government 0004 N/A N/A N/A Government 0005 N/A N/A N/A Government 0006 N/A N/A N/A Government 0007 N/A N/A N/A Government 0008 N/A N/A N/A Government 0009 N/A N/A N/A Government 0010 N/A N/A N/A Government 0011 N/A N/A N/A Government 1001 N/A N/A N/A Government 1002 N/A N/A N/A Government 1003 N/A N/A N/A Government 1004 N/A N/A N/A Government 1005 N/A N/A N/A Government 1006 N/A N/A N/A Government 1007 N/A N/A N/A Government 1008 N/A N/A N/A Government 1009 N/A N/A N/A Government 1010 N/A N/A N/A Government 2001 N/A N/A N/A Government

2002 N/A N/A N/A Government 2003 N/A N/A N/A Government 2004 N/A N/A N/A Government 2005 N/A N/A N/A Government 2006 N/A N/A N/A Government 2007 N/A N/A N/A Government 2008 N/A N/A N/A Government 2009 N/A N/A N/A Government 2010 N/A N/A N/A Government 3001 N/A N/A N/A Government 3002 N/A N/A N/A Government 3003 N/A N/A N/A Government 3004 N/A N/A N/A Government 3005 N/A N/A N/A Government 3006 N/A N/A N/A Government 3007 N/A N/A N/A Government 3008 N/A N/A N/A Government 3009 N/A N/A N/A Government 3010 N/A N/A N/A Government 4001 N/A N/A N/A Government 4002 N/A N/A N/A Government 4003 N/A N/A N/A Government 4004 N/A N/A N/A Government 4005 N/A N/A N/A Government 4006 N/A N/A N/A Government 4007 N/A N/A N/A Government 4008 N/A N/A N/A Government 4009 N/A N/A N/A Government 4010 N/A N/A N/A Government 4011 N/A N/A N/A Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

0001 N/A N/A N/A N/A

0002 N/A N/A N/A N/A

0003 N/A N/A N/A N/A

0004 N/A N/A N/A N/A

0005 N/A N/A N/A N/A

0006 N/A N/A N/A N/A

0007 N/A N/A N/A N/A

0008 N/A N/A N/A N/A

0009 N/A N/A N/A N/A

0010 N/A N/A N/A N/A

0011 N/A N/A N/A N/A

1001 N/A N/A N/A N/A

1002 N/A N/A N/A N/A

1003 N/A N/A N/A N/A

1004 N/A N/A N/A N/A

1005 N/A N/A N/A N/A

1006 N/A N/A N/A N/A

1007 N/A N/A N/A N/A

1008 N/A N/A N/A N/A

1009 N/A N/A N/A N/A

1010 N/A N/A N/A N/A

2001 N/A N/A N/A N/A

2002 N/A N/A N/A N/A

2003 N/A N/A N/A N/A

2004 N/A N/A N/A N/A

2005 N/A N/A N/A N/A

2006 N/A N/A N/A N/A

2007 N/A N/A N/A N/A

2008 N/A N/A N/A N/A

2009 N/A N/A N/A N/A

2010 N/A N/A N/A N/A

3001 N/A N/A N/A N/A

3002 N/A N/A N/A N/A

3003 N/A N/A N/A N/A

3004 N/A N/A N/A N/A

3005 N/A N/A N/A N/A

3006 N/A N/A N/A N/A

3007 N/A N/A N/A N/A

3008 N/A N/A N/A N/A

3009 N/A N/A N/A N/A

3010 N/A N/A N/A N/A

4001 N/A N/A N/A N/A

4002 N/A N/A N/A N/A

4003 N/A N/A N/A N/A

4004 N/A N/A N/A N/A

4005 N/A N/A N/A N/A

4006 N/A N/A N/A N/A

4007 N/A N/A N/A N/A

4008 N/A N/A N/A N/A

4009 N/A N/A N/A N/A

4010 N/A N/A N/A N/A

4011 N/A N/A N/A N/A

CLAUSES INCORPORATED BY REFERENCE

52.202-1 Definitions NOV 2013 52.203-3 Gratuities APR 1984 52.203-5 Covenant Against Contingent Fees MAY 2014 52.203-6 Restrictions On Subcontractor Sales To The Government SEP 2006 52.203-7 Anti-Kickback Procedures MAY 2014 52.203-8 Cancellation, Rescission, and Recovery of Funds for Illegal or

Improper Activity

MAY 2014

52.203-10 Price Or Fee Adjustment For Illegal Or Improper Activity MAY 2014 52.203-12 Limitation On Payments To Influence Certain Federal

Transactions

OCT 2010

52.204-6 Data Universal Numbering System Number JUL 2013 52.204-7 System for Award Management JUL 2013 52.204-10 Reporting Executive Compensation and First-Tier

Subcontract Awards

OCT 2015

52.214-34 Submission Of Offers In The English Language APR 1991 52.215-2 Audit and Records--Negotiation OCT 2010 52.215-11 Price Reduction for Defective Certified Cost or Pricing Data--

Modifications

AUG 2011

52.215-13 Subcontractor Certified Cost or Pricing Data--Modifications OCT 2010

52.215-21 Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data -- Modifications

OCT 2010

52.215-22 Limitations on Pass-Through Charges--Identification of Subcontract Effort

OCT 2009

52.223-6 Drug-Free Workplace MAY 2001 52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.229-3 Federal, State And Local Taxes FEB 2013 52.232-9 Limitation On Withholding Of Payments APR 1984 52.232-23 Assignment Of Claims MAY 2014 52.244-6 Subcontracts for Commercial Items JUN 2016 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7001 Prohibition On Persons Convicted of Fraud or Other Defense- Contract-Related Felonies

DEC 2008

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013 252.204-7000 Disclosure Of Information AUG 2013 252.204-7004 Alt A System for Award Management Alternate A FEB 2014 252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

DEC 2015

252.204-7009 Limitations on the Use or Disclosure of Third-Party Contractor Reported Cyber Incident Information

DEC 2015

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting.

DEC 2015

252.205-7000 Provision Of Information To Cooperative Agreement Holders DEC 1991 252.209-7004 Subcontracting With Firms That Are Owned or Controlled By

The Government of a Country that is a State Sponsor of Terrorism

OCT 2015

252.215-7000 Pricing Adjustments DEC 2012 252.219-7003 Small Business Subcontracting Plan (DOD Contracts)--Basic MAR 2016 252.225-7002 Qualifying Country Sources As Subcontractors AUG 2016 252.225-7003 Report of Intended Performance Outside the United States and Canada--Submission with Offer

OCT 2015

252.225-7004 Report of Intended Performance Outside the United States and Canada--Submission after Award

OCT 2015

252.226-7001 Utilization of Indian Organizations and Indian-Owned Economic Enterprises, and Native Hawaiian Small Business Concerns

SEP 2004

252.227-7013 Rights in Technical Data--Noncommercial Items FEB 2014 252.227-7014 Rights in Noncommercial Computer Software and

Noncommercial Computer Software Documentation

FEB 2014

252.243-7002 Requests for Equitable Adjustment DEC 2012 252.244-7000 Subcontracts for Commercial Items JUN 2013

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 01/05/17) 27

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 retains all ownership of the categories of confidential information listed below.

The Contractor's right to use the confidential data shall be limited to those necessary to perform its obligations under the contract. Upon conclusion or termination of this contract, the Contractor shall deliver and/or dispose of all copies of the confidential data, in accordance with directions it receives from the Contracting Officer.

Personally Identifying Information ("PII"); and 2. Protected Health Information ("PHI").

10.1.1 Reserved

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…