HT0011-16-R-0040-Global_NAL-Attachment_6-Draft_QASP-11-2-16.doc

HT0011-16-R-0040-Global NAL-Attachment 6- draft QASP-11-02-16

ATTACHMENT 6: Quality Assurance Surveillance Plan (DRAFT)

Title: Global Nurse Advice Line Contract Description: 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.

The Global NAL will offer all eligible Military Health System (MHS) beneficiaries 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 NAL also offers care coordination services, civilian network provider locator support, and specified Military Treatment Facility (MTF) appointing services for eligible MHS beneficiaries.

Contractor’s name:

1. PURPOSE.

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

· What will be monitored

· How monitoring will take place

· Who will conduct the monitoring

· How monitoring efforts and results will be documented This QASP does not detail how the Contractor accomplishes the work. Rather, the QASP is created with the premise that the Contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance. In addition, the QASP should recognize that unforeseen and uncontrollable situations may occur.

This QASP is a “living document” and the Government may review and revise it on a regular basis to ensure that the QASP remains a valid, useful, and enforceable document. However, the Government will coordinate changes with the Contractor. Copies of the original QASP and revisions will be provided to the Contractor and Government officials implementing surveillance activities.

The following FAR clauses may apply depending on contract type:

52.212-4(a)-Inspection/Acceptance-Contract Terms and Conditions-Commercial Items

2. Government Roles and Responsibilities.

The following Government personnel are responsible for overseeing and coordinating surveillance activities.

a. Contracting Officer (CO) - The CO is responsible for ensuring performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and safeguard the interests of the United States in the contractual relationship. The CO is also responsible for ensuring that the Contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the Contractor’s performance.

Assigned CO:

Organization or Agency:

Telephone:

Email:

b. Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and is responsible for ensuring proper Government surveillance of the Contractor’s performance. The COR is responsible for keeping a quality assurance file and at the conclusion of the contract, or when requested by the CO, providing corresponding documentation to the CO. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf. The Contractor shall refer any changes they deem may affect contract price, terms, or conditions to the CO for action.

Assigned COR:

Telephone:

Email:

c. Other Key Government Personnel –

Title:

Telephone:

Email:

3. Contractor Representatives:

The following employees of the Contractor serve as the Contractor’s Program Manager and Task Manager for this contract.

a. Project Manager:

Telephone:

Email:

b. Task Manager :

Telephone:

Email:

c. Other Contractor Personnel Technical POC:

Tel:

Email:

4. Performance Standards.

Performance standards define desired services. The Government performs surveillance to determine if the Contractor exceeds, meets or does not meet these standards.

The Performance Requirements Summary Matrix, Technical Exhibit 1 in the Performance Work Statement (PWS) includes performance standards. The Government will use these standards to determine Contractor performance and will compare Contractor performance to the Acceptable Quality Level (AQL).

5. Incentives.

The Government will use past performance and exercising the next option period as incentives. Incentives will be based on the following performance threshold ratings of outstanding, very good, satisfactory, marginal, and unsatisfactory. Information about the performance threshold ratings can be found in paragraph 7 of this document.

Performance Requirements Summary Matrix

Incentive

Total number of validated complaints not to exceed .1% of all calls per year

Very Good – 96% - 98% Satisfaction Survey Results and/or

Total number of validated complaints not to exceed .25% of all calls per year

Satisfactory – 95% Satisfaction Survey Results and/or

Total number of validated complaints not to exceed .5% of all calls per year

Marginal – 91% – 94%

Satisfaction Survey Results and/or

Total number of validated complaints not to exceed .75% of all calls per year

Unsatisfactory – 90% or less

Satisfaction Survey Results and/or

Total number of validated complaints not to exceed 1% of all calls per year NAL Satisfaction Survey and direct observations, written or oral validated customer complaints

Past Performance Rating

Exercise of the Option

Total number of validated complaints not to exceed .1% of all calls per year

Very Good – 96% - 98% Satisfaction Survey Results and/or

Total number of validated complaints not to exceed .25% of all calls per year

Satisfactory – 95% Satisfaction Survey Results and/or

Total number of validated complaints not to exceed .5% of all calls per year

Marginal – 91% – 94%

Satisfaction Survey Results and/or

Total number of validated complaints not to exceed .75% of all calls per year

Unsatisfactory – 90% or less

Satisfaction Survey Results and/or

Total number of validated complaints not to exceed 1% of all calls per year

NAL Satisfaction Survey and direct observations, written or oral validated customer complaints

Past Performance Rating

Exceptional – 99.8% or above for all NAL encounters

Very Good – 99.1 - 99.6% of all NAL encounters

Satisfactory – 98.5% - 99.0% of all NAL encounters

Marginal – 98.0% to 98.4% of all NAL encounters

Unsatisfactory – Less than 98% of all NAL encounters

Exercise of the Option

Very Good – 96% - 98% on time

Satisfactory – 95% on time

Marginal – 91 - 94% on time

Unsatisfactory – 90% or less on time

Exercise of the Option

drop rate of less than 5%, where abandonment is defined as both: Calls which reach the initial stage with the customer service rep, but terminate prior to completing nurse-triage, and calls which reach nurse triage but terminate prior to completing the care coordination process

URAC Health Call Center Accreditation Standard

Standard: 95% of the time during the reporting period Exceptional – 99% - 100% of the time during the reporting period

Very Good – 96% - 98% of the time during the reporting period

Satisfactory – 95% of the time during the reporting period

Marginal – 91% - 94%% of the time during the reporting period

Unsatisfactory – 90% of the time during the reporting period

Exercise of the Option

Global NAL calls are answered within 30 seconds of the beginning of the call and at all exchange points

Standard: 95% of the time during the reporting period Exceptional – 99% - 100% of the time during the reporting period

Very Good – 96% - 98% of the time during the reporting period

Satisfactory – 95% of the time during the reporting period

Marginal – 91% - 94%% of the time during the reporting period

Unsatisfactory – 90% of the time during the reporting period

Exercise of the Option

Standard: 99% of all applicable NAL encounters

Exceptional – 99.95% or above of all applicable NAL encounters

Very Good – 99.91% - 99.94% of all applicable NAL encounters

Satisfactory – 98.5% - 99.0% of all applicable NAL encounters

Marginal – 98.0% - 98.4% of all applicable NAL encounters

Unsatisfactory – Less than 98% of all applicable NAL encounters

Exercise of the Option

See Para 5.9 Crisis Call

Standard: 99.8% of all applicable NAL encounters Exceptional – 99.95% or above of all applicable NAL encounters

Very Good – 99.85% - 99.94% of all applicable NAL encounters

Satisfactory – 99.80% - 99.84% of all applicable NAL encounters

Marginal – 99.6% - 99.7% of all applicable NAL encounters

Unsatisfactory – 99.5% or less of all applicable NAL encounters

Exercise of the Option

Standard: 99.8% of all NAL encounters Exceptional – 99.95% or above of all NAL encounters

Very Good – 99.85% - 99.94% of all NAL encounters

Satisfactory – 99.80% - 99.84% of all NAL encounters

Marginal – 99.6% - 99.7% of all NAL encounters

Unsatisfactory – 99.5% or less of all NAL encounters

QA observations and reports

Random Sampling Past Performance Rating

Exercise of the Option

See Para 5.12 Real Time Database and 5.13 Business Intelligence Reporting Capability

Standard: 99.8% availability of the system Exceptional – 99.95% or above availability of the system

Very Good – 99.90% - 99.94% availability of the system

Satisfactory – 99.8% availability of the system

Marginal – 99.6% - 99.7% availability of the system

Unsatisfactory – 99.5% or less availability of the system

Various methods exist to monitor performance. The COR will use the surveillance methods listed below in the administration of this QASP.

Regardless of the surveillance method, the COR will contact the Contractor's task manager or on-site representative when a defect is identified and inform the manager of the specifics of the problem. The COR will be responsible for monitoring the contractor’s performance in meeting a specific performance standard/AQL.

a. OBSERVATION. Periodic observations of NAL encounter record documentation shall be performed by the NAL Program Management Office (PMO). Direct observations of NAL contractor staff performing eligibility verification, telehealth nursing, care coordination, and customer service duties may also be performed by the NAL PMO.

b. PERIODIC INSPECTION. Inspections may be scheduled as required during the term of the contract period. However, a final annual inspection will be conducted to ensure compliance and that all contract tasks are completed and acceptable.

c. USER SURVEY. User survey results will be reviewed with the NAL contractor to evaluate NAL user satisfaction.

d. BENEFICARY SATISFACTION SURVEY. A NAL beneficiary satisfaction survey may be administered by a third party to measure the satisfaction of NAL callers.

e. VALIDATED USER/CUSTOMER COMPLAINTS. The NAL PMO QA will review all written or oral complaints submitted to the Government or to the NAL contractor. The Government will review submitted complaints with the contractor for appropriate action.

f. RANDOM SAMPLING. The NAL PMO will periodically monitor and review NAL calls using random sampling methodologies. These reviews will focus on the quality of the nursing algorithms and guidelines used by the NAL telehealth nurses. The NAL PMO will also periodically review NAL caller encounter reports using random sampling methodologies. These reviews will focus on the quality and accuracy of these reports. Any discrepancies will be noted in CPARS.

g. PROGRESS/STATUS UPDATE MEETINGS. The NAL PMO will conduct monthly meetings with the NAL Contractor to discuss the expenditures, billings, progress, status, monthly meeting minutes, and any problems/ issues encountered in the performance of this contract.

h. PERFORMANCE REPORTING. The NAL PMO will conduct thorough analysis of all monthly performance reports and all quarterly data analysis reports. The COR shall determine if all deliverables are on time and accurate throughout the contract period. The COR shall monitor by reviewing reports to ensure contract deliverables are completed in a timely manner and accurately with appropriate quality control measures.

Note: Surveillance results may be used as the basis for actions (to include re-performance then invoice rejection or equitable price adjustment) against the contractor. In such cases, 52.212-4(a) clause in the Contract becomes the basis for the CO’s actions.

7. Ratings.

Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used:

8. DOCUMENTING PERFORMANCE.

a. Acceptable Performance.

The Government will document positive performance. A report template is attached. Any report may become a part of the supporting documentation for fixed fee payments, incentive fee payments, or other actions.

b. Unacceptable performance.

When unacceptable performance occurs, the COR will inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR will document the discussion and place it in the COR file.

When the COR determines formal written communication is required, the COR will prepare a Contract Discrepancy Report (CDR), and present it to the Contractor's task manager or on-site representative. A CDR template is attached to this QASP.

The contractor will acknowledge receipt of the CDR in writing. The CDR will specify if the Contractor is required to prepare a corrective action plan to document how the Contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the Contractor has to present this corrective action plan to the COR. The Government shall review the Contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for contract payment deductions, fixed fee deductions, incentive fee nonpayment, or other actions deemed necessary by the CO.

9. Frequency of Measurement.

a. Frequency of Measurement.

During the contract, the COR will take periodic measurements, annually or as needed and shall analyze whether the negotiated frequency of measurement is appropriate for the work being performed.

b. Frequency of Performance Assessment Meetings.

The COR will meet with the contractor annually or as needed to assess performance and will provide a written assessment.

Prepared by:

Signature – Contracting Officer’s Representative

Performance Report

< This template will be used to formally document surveillance. >

1. CONTRACT NUMBER: <insert number>

2. PREPARED BY: (Name of COR) <insert name>

3. DATE (and time observed discrepancy):

4. OBSERVATION:

<Examples of items to include in a report are:

- Method of surveillance.

- How frequently you conducted surveillance.

- Surveillance results.

- Number of observations.> Prepared by: <Enter COR’s name>

Signature – Contracting Officer’s Representative

Date

Contract Discrepancy Report (CDR)

< This template will be used to formally document discrepancies. >

1. Contract Number: < insert number >

2. TO: (Contractor Task Manager or on-site representative) < insert name >

3. FROM: (Name of COR) < insert name >

4. DATE (and time observed discrepancy):

5. DISCREPANCY OR PROBLEM: < Describe in detail. Identify any attachments. >

6. CORRECTIVE ACTION PLAN: A written corrective action plan < is / is not > required.

< If a written corrective action plan is required include the following. > The written Corrective Action Plan will be provided to the undersigned not later than < # days after receipt of this

CDR. >

Prepared by: < Enter COR’s name >

Signature – Contracting Officer’s Representative

Received by:

Signature - Contractor Task Manager or on-site representative

SHAPE \* MERGEFORMAT

< The COR may initiate a CDR at any time, including whenever the number of monthly recorded defects for a performance standard exceeds the allowable number of defects; anytime unacceptable performance is determined critical in nature and requires formal corrective action; and whenever an unfavorable trend is detected in contractor performance. >