Integrated Syndemic Capacity Development Programming for Indian Country PWS_Draft.docx

Performance Work Statement Integrated Syndemic Capacity Development Programming for Indian Country Contract 3/21/2024

Integrated Syndemic Capacity Development Programming for Indian Country

1.1 Mission

The mission of the Indian Health Service is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

1.2 Background

This contract will comprehensively address the Indigenous HIV/AIDS Syndemic Strategy: Weaving Together the National HIV, STI, and Viral Hepatitis Plans. Focusing on Indian Health Service (IHS), tribal and urban Indian health (I/T/U) organizations, and clinics, our team will utilize a syndemic approach that acknowledges and addresses the interconnectedness of HIV with other health disparities in American Indian & Alaska Native (AI/AN) communities. This proposal aims to improve syndemic-related health outcomes and reduce disparities for AI/AN people by increasing capacity, fostering resilience, and creating sustainable systemic strategies in I/T/U health organizations and clinics.

1.3 Scope

The IHS Division of Clinical and Community Services (DCCS) will require the services of contractor support to develop, implement, and evaluate Integrated Syndemic Capacity Development Programming for the IHS system that includes Federal, Tribal, and Urban Indian Health Organization (I/T/U) staff.

With guidance from IHS, the contractor will utilize a syndemic approach that acknowledges and addresses the interconnectedness of HIV with other health disparities in AI/AN communities. By adopting a holistic and indigenous perspective, our program aims to improve syndemic-related health outcomes and reduce associated disparities for AI/AN communities by increasing capacity, fostering resilience, and creating sustainable systemic strategies in I/T/U health organizations and clinics. The main goal of this project is to reduce syndemic-related health disparities within AI/AN communities by implementing culturally relevant and community-specific capacity development, technical assistance, collaboration, and interventions encompassing systemic conditions.

In line with (1) Ending the HIV Epidemic in the U.S. (EHE); (2) The HIV National Strategic Plan: A Roadmap to End the Epidemic in the United States (2022– 2025); (3) The Viral Hepatitis National Strategic Plan for the U.S.: A Roadmap to Elimination 2021–2025; (3) The Sexually Transmitted Infections National Strategic Plan for the United States 2021-2025; and (4) The Indigenous HIV/AIDS Syndemic Strategy: Weaving Together the National HIV, STI, and Viral Hepatitis Plans, the objectives of this work are as follows:

Syndemic Approach Objective: Demonstrate the embedding of a syndemic approach into I/T/U healthcare systems to address interconnected health disparities across HIV, HCV, STI, mental health, substance use, and social determinants.

Activities:

· Develop and deliver training and capacity-building programs emphasizing syndemic-focused care across multiple conditions

· Discover, identify, and document best practices within I/T/U clinics on system-level policies and practices about syndemic-related disease states and social determinants of health

· Disseminate relevant policies, guidelines, and training curricula that support non-stigmatizing, culturally competent care for HIV, HCV, STI, mental health, and substance use

· Promote innovative models of syndemic care. For example: (1) Increasing the use of innovative syndemic testing methods (field testing, home testing); (2) Rethinking access to care and how to reach people who are not coming or cannot come into the clinic; and (3) Status Neutral HIV Prevention and Care, or Status Neutrality – a whole person approach to HIV prevention and care that emphasizes high-quality care to engage and retain people in services regardless of if the services are for HIV treatment or prevention, that meet people where they are for testing and treatment, including harm reduction programs, street medicine programs, and home-based programs.

Capacity Development Objective: Build organizational and individual capacity to implement syndemic-focused care across HIV, HCV, and STI

Activities:

· Increase knowledge and uptake of best practices among I/T/U clinics by sharing programs and policies and delivering education that strengthens the healthcare workforce skills and competencies for HIV, HCV, syphilis, and syndemic care.

· Ensure that cultural humility is embedded into all capacity development facilitation, training, and knowledge sharing.

Collaboration Objective: Demonstrate an increase in collaborative partnerships with AI/AN agencies and federal, state, and county health systems to ensure community-driven and sustainable solutions addressing syndemic conditions.

Activities:

· Engage with local communities, Tribal leaders, public health agencies, and relevant stakeholders to ensure a collaborative and community-driven approach to syndemic capacity development.

· Establish mechanisms for ongoing collaboration and communication between stakeholders focused on HIV, HCV, STI, mental health, substance use, and other syndemic conditions.

· Identify and document impactful collaborations between Tribal, Federal, state, and county health systems for prevention, education, biomedical interventions, data and informatics, outreach, resourcing, equity, and de-stigmatization.

IHS will require contractor to document a program monitoring and evaluation plan with a logic model, clearly identified metrics and evaluation protocols.

IHS will guide the contractor to create a monitoring and evaluation plan as follows:

1. Define clear goals and objectives

a. Clearly articulate the overall goals of the project

b. Break down goals into specific, measurable, achievable, relevant, and timebound (SMART) objectives.

2. Identify key performance indicators

a. Determine the indicators that will measure towards each objective

b. Ensure that key performance indicators are specific, measurable, and aligned with goals and objectives.

3. Develop baseline data when available

a. Collect baseline data before the project begins to establish a starting point for evaluation

4. Select monitoring and evaluation methods

a. Determine the methods and tools for data collection. This can include surveys, interviews, focus groups, observations, and document reviews

b. Choose a mix of quantitative and qualitative methods to provide a comprehensive understanding of progress

5. Establish a monitoring schedule

a. Define the frequency and timing of data collection activities

b. Ensure the monitoring activities are aligned with project milestones and critical events.

6. Identify responsible parties

a. Assign roles and responsibilities for monitoring and evaluation tasks.

b. Clarify who will collect, analyze, and report data.

7. Develop data analysis and reporting procedures

a. Specify how data will be analyzed, interpreted, and reported.

b. Define the reporting format, frequency, and audience for monitoring and evaluation reports.

8. Include feedback mechanisms

a. Establish mechanisms for obtaining feedback from stakeholders and partners.

b. Use feedback to make adjustments to the project.

2 General Requirements This section describes the general requirements for this effort. The following sub-sections provide details of various considerations on this effort. The following schedule of tasks and deliverables outlines the requirements necessary to organize, develop, facilitate, manage, and evaluate comprehensive, Integrated Syndemic Capacity Development Programming.

2.1 Non-Personal Services

The Government shall neither supervise contractor employees nor control the method by which the contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor employees. It shall be the responsibility of the contractor to manage its employees and to guard against any actions that are of the nature of personal services, or give the perception of personal services. If the contractor believes that any actions constitute or are perceived to constitute personal services, it shall be the contractor's responsibility to notify the Procuring Contracting Officer (PCO) immediately.

2.2 Business Relations

The contractor shall successfully integrate and coordinate all activities needed to execute the requirement. The contractor shall manage the timeliness, completeness, and quality of problem identification. The contractor shall provide corrective action plans, proposal submittals, timely identification of issues, and effective management of subcontractors. The contractor shall seek to ensure customer satisfaction and the professional and ethical behavior of all contractor personnel.

2.3 Contract Administration and Management

The following subsections specify requirements for contract, management, and personnel administration.

2.4 Contract Management

The contractor shall establish clear organizational lines of authority and responsibility to ensure effective management of the resources assigned to the requirement. The contractor must maintain continuity between the support operations between the contractor's corporate offices and Indian Health Service Division of Clinical and Community Services.

2.5 Contract Administration

The contractor shall establish processes and assign appropriate resources to effectively administer the requirement. The contractor shall respond to Government requests for contractual actions in a timely fashion. The contractor shall have a single point of contact between the Government and Contractor personnel assigned to support contracts or task orders. The contractor shall assign work effort and maintaining proper and accurate time keeping records of personnel assigned to work on the requirement.

The contractor will meet with the Contracting Officer Representative (COR) and IHS officials within 30 days of the contract award to become acquainted with the DCCS staff, review the Performance Work Statement (PWS), discuss timelines and deliverables, and to begin initial planning. The contractor and COR will hold a kick-off meetings at the beginning of the base and each option year of the contract to revisit and make adjustments (if necessary) to the comprehensive action plan, communications plan, evaluation plan, and project plan, to discuss ongoing tasks in the PWS, and new deliverables for the option year.

2.6 Personnel Administration

The contractor will provide the following management and support as required. The contractor shall maintain the currency of their employees by providing initial and refresher training as required to meet the PWS requirements. The contractor will make necessary travel arrangements for employees. The contractor shall provide the necessary infrastructure to support contract tasks.

The contractor will provide administrative support to employees in a timely fashion (timekeeping, leave processing, pay, emergency needs).

2.7 Subcontract Management

The contractor will be responsible for any subcontract management necessary to integrate work performed on this requirement and will be responsible and accountable for subcontractor performance on this requirement. The prime contractor will manage work distribution to ensure there are no Organizational Conflict of Interest (OCI) considerations. Contractors may add subcontractors to their team after notification to the Procuring Contracting Officer (PCO) or Contracting Officer Representative (COR). Cross-teaming may or may not be permitted.

2.8 Contractor Personnel, Disciplines, and Specialties

The contractor will accomplish the assigned work by employing and utilizing qualified personnel with appropriate combinations of education, training, and experience. The contractor will match personnel skills to the work or task with a minimum of under/over employment of resources. The contractor will ensure the labor categories as defined in the Labor Categories document (see attachment), labor rates, and man-hours utilized in the performance of each Task Order (PWS line item) issued hereunder will be the minimum necessary to accomplish the task.

The Contractor will provide the necessary resources and infrastructure to manage, perform, and administer the contract.

2.9 Location and Hours of Work

Accomplishment of the results contained in this PWS requires work at various contractor, subcontractor, and Government facilities (mainly in the continental United States). Normal workdays are Monday through Friday except US Federal Holidays. Workers typically work eight (8) hours per day, 40 hours per week. Flextime workers start not earlier than 0600 and not later than 0900. Core hours of work are from 0900 to 1500 daily. All employees are expected to be available during core hours.

2.10 Travel / Temporary Duty (TDY)

If travel is required, all travel requirements (including plans, agenda, itinerary, or dates) will be pre-approved by the government (subject to local policy procedures) and is on a strictly cost-reimbursable basis. Costs for travel shall be billed in accordance with the regulatory implementation of Public Law 99-234 and FAR 31.205-46 Travel Costs (subject to local policy & procedures; may reference FAR).

3 Performance Requirements

The period of performance for this task order shall be 12 months from the date of award with four (4) 12-month option periods. All contract-related activities must be completed within the performance period.

The following sections specify the Performance Objectives and Performance Elements for the contract.

3.1 Monthly Reports

The Contractor will meet with the Contract Officer Representative (COR) and Program Manager (PM) by teleconference (meeting frequency will be determined by the COR) and will submit a written report at least monthly to provide an update of progress toward meeting deliverables, challenges encountered, and proposed solutions to the challenges.

3.2 Annual Reports

The contractor will prepare a written annual report, after consulting with the COR and PM regarding the format and approach of the report, and provide a draft for comments. The final report will be due 30 days prior to the conclusion of the contract to allow for review and revisions.

3.4 Cultural Competency

The contractor will ensure that personnel who interact with stakeholders, Tribes, and tribal personnel communicate in a culturally appropriate and respectful manner. An example: A Guide to Build Cultural Awareness: American Indian and Alaska Native at local libraries or similar information available publicly. This requirement does not encourage or require any costs incurred by interested parties.

5.3 Technical Assistance

The contractor will respond to all inquiries from IHS, Tribal, and urban programs in a timely manner.

4.1 Security and Safety

DD Forms 254: Overarching security requirements and contractor access to classified information shall be as specified in the basic DD Form 254, which will be further identified in the DD Form 254 for each TO, as required. All contractor personnel with access to unclassified information systems, including e-mail, shall have at a minimum a favorable National Agency Check (NAC).

Visitor Group Security Agreement. The contractor shall sign a Contractor Visitor Group Security Agreement to protect classified information involved in performance under this contract or Task Order. The Agreement will outline responsibilities in the following areas: Contractor security supervision; Standard Practice Procedures; access, accountability, storage, and transmission of classified material; marking requirements; security education; personnel security clearances; reports; security checks; security guidance; emergency protection; protection of government resources; DD Forms 254; periodic security reviews; and other responsibilities, as required.

4.2 Reporting

The contractor shall follow the reporting plan submitted as part of the proposal and keep the Government fully informed of status throughout the contract period. Throughout the contract periods, it is essential that attention be given to minimize interruptions or delays to work in progress that would impact the mission.

The Contractor shall provide status reports to the COR to include but not be limited to expense variance to budget, logistical updates, attendee metrics, attendee training evaluations, project plan tracking, evaluation data, and other items as determined by the COR. The Contractor shall deliver status reports by email or postal service no less than every month but may be adjusted as determined necessary by the COR throughout the course of the project. Electronic reports shall be presented in Microsoft Office format and approved by the COR. The monthly status reports shall be discussed at the Start-Up meeting.

The Contractor shall provide to the COR, annual performance reports that include but are not limited to project plan status and accomplishments, fiscal accountability, evaluation data, sub-Contractor performance reports (if applicable), and a Contractor self-evaluation report. The Contractor shall provide a written outline of the annual report to the COR for approval according to the deliverable schedule. The annual reports shall be delivered by e-mail and postal service according to the deliverable schedule before the end of the contract period. The annual report shall be discussed at the Start-up meeting.

4.3 Storage and Disposition of Materials

The disposition of any national training and marketing materials will be determined in the Start-Up meeting. Storage should be available as soon as national materials are generated. A disposition schedule will be discussed with the COR during the Start-Up meeting.

4.4 Correspondence and Conference Calls

The Contractor shall provide quarterly updates and correspondence as determined necessary by the COR. The quarterly conference call schedule may be adjusted as determined by the COR. Updates and correspondence include but are not limited to summaries, conference call agendas and minutes, and any other items deemed necessary by the COR.

4.5 Deliverables

The contractor shall provide deliverables as described in subsequent task orders. Deliverables shall be specified by the government. Format and delivery schedule for deliverables shall be outlined in CDRLs and/or other means TBD.

4.6 Deliverables Table

Contract Administration