Attachment 6 VCE Vision Care Coordination QASP.docx

DEFENSE HEALTH AGENCY

Quality Assurance Surveillance Plan (QASP) 27 February 2025

Vision Center of Excellence Vision Care Coordination Contract Number: TBD

Contract Description:

To support DoD and VA requirements for early identification of the vision care coordination needs of the Service Members (SM) from referrals to ocular specialists to diagnosis and treatment of the eye injury and/or vision impairment or dysfunction.

Contractor’s Name: TBD

1. Purpose

This Quality Assurance Surveillance Plan (QASP) is a government-developed document used to determine if the contractor’s performance meets the performance standards contained in the contract. The QASP establishes procedures on how this assessment/ inspection process will be conducted. It provides the detailed process for a continuous oversight process:

· What will be monitored

· How monitoring will take place

· Who will conduct the monitoring

· How monitoring efforts and results will be documented

The contractor is responsible for implementing and delivering performance that meets contract standards using its Quality Control Plan. The QASP provides the structure for the government’s surveillance of the contractor’s performance and their Quality Assurance/Quality Control (QA/QC) actions to assure they meet contract standards. It is the government’s responsibility to be objective, fair and consistent in evaluating contractor performance.

The QASP is not part of the contract, nor is it intended to duplicate the contractor’s quality control plan. This QASP is a living document. Flexibility in the QASP is required to allow for an increase or decrease in the level of surveillance necessary based on contractor performance.

The government may provide a copy of the QASP to the contractor to facilitate open communication. In addition, the QASP should recognize that unforeseen or uncontrollable circumstances might occur that are outside the control of the contractor.

Bottom line, the QASP should ensure early identification and resolution of performance issues to minimize impact on mission performance.

2. Authority

Authority for issuance of this QASP is provided under Part 46 of the Federal Acquisition Regulation, Inspection of Services clauses, which provides for inspection, acceptance and documentation of the service called for in the contract or order. This acceptance is to be executed by the contracting officer or a duly authorized representative.

3. Roles and Responsibilities

The following personnel shall oversee and coordinate surveillance activities.

Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also ensure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO shall also determine the final assessment of the contractor’s performance.

Additionally, the CO shall include a requirement in the quality assurance surveillance plan to revalidate all key personnel annually to determine whether the contractors meet the labor categories specified in the contract.

The CO shall maintain documentation in the contract files that demonstrates their review and approval of initial and replacement contractor employees in key personnel positions.

The CO shall include a requirement in information technology service contracts QASPs to review a sample of non‑key personnel quarterly to determine whether the contractor personnel meet the labor categories specified in the contract.

Assigned CO: Leslie Nelsen Organization or Agency: DHACA (PS-CD) Telephone: 703.681.4267 Email: leslie.s.nelson7.civ@health.mil

Contracting Officer’s Representative (COR) The COR is responsible for providing continuous technical oversight of the contractor’s performance. The COR uses the QASP to conduct the oversight/surveillance process. The COR shall keep a Quality Assurance file that accurately documents the contractor’s actual performance. The purpose is to ensure that the contractor meets the performance standards contained in the contract. The COR is responsible for reporting early identification of performance problems to the CO. The COR is required to provide an annual performance assessment to the CO which will be used in documenting past performance. The QASP is the primary tool for surveillance of the contractor’s quality program and help the COR to document contractor performance. The COR is not empowered to make any contractual commitments or to authorize any contractual change on the Government’s behalf.

Assigned COR: Patty A. Morris Organization or Agency: Defense Health Agency Telephone: 703.681.8211 Email: patty.a.morris.civ@health.mil

Contractor Representatives

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

Contractor Program Manager

TBD

Telephone: TBD Email: TBD

Contractor Task Manager TBD (On-site Coordinator) Telephone: TBD Email: TBD

Other Key Contractor Personnel

TBD

Title: TBD Telephone: TBD Email: TBD

4. Performance Requirements and Method of Surveillance

4.1. Contract Surveillance

The goal of the QASP is to ensure that contractor performance is effectively monitored and documented. The COR’s contribution is their professional, non-adversarial relationships with the CO, PM and the contractor, which enables positive, open and timely communications. The foundation of this relationship is built upon objective, fair, and consistent COR evaluations of contractor performance against contract requirements. The COR uses the methods contained in this QASP to ensure the contractor is in compliance with contract requirements. The COR function is responsible for a wide range of surveillance requirements that effectively measure and evaluate the contractor’s performance. Additionally, this QASP is based on the premise that the contractor, not the government, is responsible for management and QC/QA actions to successfully meet the terms of the contract.

4.2. Surveillance Matrix

The Surveillance Matrix (Appendix 1) is the list of performance objectives and standards that must be performed by the contractor. This matrix details the method of surveillance and frequency the COR will use to validate and inspect these performance elements. Inspection of each element will be documented in the COR file.

DFARS 222.17 mandates including surveillance for ensuring compliance with Combatting Trafficking in Persons (CTIP) in the QASP. Use the CTIP sample checklist from PGI 222.17. See the DoD CTIP website.

Performance objectives define the desired outcomes. Performance Standards define the level of service required under the contract to successfully meet the performance objective. The inspection methodology defines how, when, and what will be assessed in measuring performance. The Government performs surveillance, using this QASP, to determine the quality of the contractor’s performance as it relates to the performance element standards. The Performance Requirement Summary (PRS) should be used to form the foundation of the COR’s inspection checklist.

4.3. Performance Rating Definitions

The performance ratings below reflect definitions at FAR 42.1503 Table 42-1. The COR will use these rating to evaluate the quality of contractor’s performance.

Performance Rating Definition

Note 1: Plus or minus signs may be used to indicate an improving (+) or worsening (-) trend insufficient to change the evaluation status.

Note 2: N/A (not applicable) should be used if the ratings are not going to be applied to a particular area for evaluation.

5. Performance Reporting

5.1. Corrective Action Report (CAR)

Describes how discrepancies are reported and resolved (see sample CAR below).

5.2. Customer Complaint Form

(See sample customer complaint form below)

5.3. Performance Assessment Report (PAR) (See sample customer PAR page 11)

DHA QASP Template V1 Appendix 1 – Surveillance Matrix

Performance Objective (The Service required—usually a shall statement from Part 5)

Performance Requirements Summary (PRS) # 1.

Regional vision care coordination at each OTC as directed by the COTR and/or OTC procedural guidance. This will include vision care coordination for other MTFs in the surrounding region as defined by the VCE.

(4)

PRS #2

Establish and maintain a viable DoD-wide vision care coordination program consisting of the regional vision care coordinator working in cooperation with the four regional OTC vision care coordinators.

PRS #3

Facilitate the movement of vision care patients between the DoD and the VA and other non-DoD providers through the establishment of processes and agreements between the DOD and other entities (VA and community providers).

PRS #4

Collect data pertaining to vision care coordination, OTC function, and the movement of patients between the DoD and other health care entities (VA and community providers) under the direction of the VCE and the respective OTCs, as a performance improvement measure for DoD vision care.

PRS # 5

The contractor shall provide coordination of care for all MTFs and DoD patients within their region.

PRS # 6

The contractor shall facilitate the care of patients throughout the entire clinical course of treatment. They shall perform to the guidelines set forth by clinical leadership at the OTC, ophthalmology, and/or optometry clinics at their MTF.

PRS # 7

The Contractor shall establish and maintain an MHS-wide network of care coordination consisting of the four (4) regional coordinators working together.

PRS # 8

The Contractor shall collect health care data, perform simple analysis, and report that data to the DOD for quality improvement in vision eye care.

PRS # 6

The Contractor shall complete all relevant training and fulfill all requirements for their scope of work and access to relevant data sources, medical records, and facilities as determined by the OTC leadership/COTR/COR (for OTC-specific work) and/or the VCE/DHA (for MHS-wide work).

Inspection Metrologies:

M1: Inspection of Reports. All reports shall be reviewed upon receipt. The reviewer will report any flaws in the document and categorize the flaws (Editorial, Format, and/or Substance).

CORRECTIVE ACTION REPORT (CAR)

(If more space is needed, use reverse and identify by number)

1. CONTRACTOR

2. CONTRACT NUMBER

3. TYPE OF SERVICES

4. FUNCTIONAL AREA

5. SUSPENSE DATE

6. CONTROL NUMBER

7. DEFICIENCY |_| MAJOR |_| MINOR

FINDING:

FINDING IMPACT:

Please respond with a written corrective action plan that details the corrective action of the cited deficiency, the cause of the deficiency, and actions taken to prevent recurrence by Suspense Date in Block 5. If date was not entered in Block 5, the contractor is not required to provide a response.

8. QUALITY ASSURANCE PERSONNEL (COR)

TYPED NAME AND GRADE

SIGNATURE AND DATE

9. ISSUING AUTHORITY

TYPED NAME AND GRADE

SIGNATURE AND DATE

10. COR RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND ACTION TAKEN TO PREVENT RECURRENCE

11. COR DETERMINATION

|_| ACCEPTED |_| REJECTED

12. CLOSE DATE

CUSTOMER COMPLAINT RECORD

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

PERFORMANCE ASSESSMENT REPORT (PAR)

(If more space is needed, use reverse and identify by number)

4. QUALITY ASSURANCE PERSONNEL (COR) SIGNATURE AND DATE

I. PERFORMANCE

7. |_| DEFICIENCY (CHECK ALL BOXES THAT APPLY)

|_| NEW

|_| REPEAT

|_| NO DEFICIENCY NOTED

8. SERVICES SUMMARY or PWS PARAGRAPH ITEM REVIEWED

II. CONTRACTOR VALIDATION

11. CONTRACTOR REPRESENTATIVE |_| CONCUR |_| NON-CONCUR

12. CORRECTIVE ACTION ESTIMATED COMPLETION DATE

13. CONTRACTOR REPRESENTATIVE CORRECTIVE ACTION AND PREVENTION OF RECURRENCE OR REASON FOR NON-CONCURRENCE OF COR CITED DEFICIENCY

III. ACTION CORRECTED

14. |_| CONCUR |_| NON-CONCUR COR SIGNATURE AND DATE

15. COR REMARKS (REQUIRED)

16. CONTRACTOR REPRESENTATIVE REMARKS

DHA QASP Template V1 16