Performance Work of Statement.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

Non-Clinical Case Management and Medical Credentialing Services

1.0 General: This is a non-personal health care services contract to provide Non-Clinical Case Management, and Medical Credentialing Services. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. The key personnel selected for contract service shall be accountable solely to the Contractor who, in turn is responsible to the Government. The Government may evaluate the quality of high level, professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered.

1.1 Scope: The Contractor shall provide all key personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished Property, to perform Case Management Services and Medical Credentialing for more than 6,200 PR Army National Guard Service Members as defined in this PWS.

1.2 Background

1.2.1 Case Management: Case Management targets Puerto Rico Army National Guard Service Members with complex, multi-system healthcare needs who require key case management or care coordination services. Originally, Case Management almost exclusively targeted in-patients with catastrophic illnesses or injuries. However, while Case Management continues to focus on catastrophic illness or injury, Case Management practices are also intensely directed at addressing chronic conditions that are more prevalent in the general patient population as well as the medical readiness and deployability requirements. Case managers are expected to engage leadership and the State Surgeon’s Office by providing ongoing and consistent patient recommendations and medical administrative services. The Non-Clinical Case Management Team (NCCMT) requires the expertise to facilitate, through review of documentation, military regulations and other authorized data the rendering of non-clinical administrative services. The medical documentation of individual Soldiers, obtained by Case Management, will be utilized in the production of Narrative Summaries (NARSUMs), profiling, referrals, reports, investigations, medical board packets, waiver requests, and medical readiness standards. The ultimate goals are to produce real-time reports based on complete, accurate data. The minimum goal for overall medical readiness is more than 90% of Service members FMR and 95% deployable. The team will consist of Case Managers and Care Coordinators. Bachelor’s degree required, but nursing license preferred for Case Manager hires that draft narrative summaries, review medical information, advise personnel on duty restrictions, recommend profiling restrictions, waiver recommendations, and advise the Deputy State Surgeon (DSS) on deployment ability. Care Coordinators collect medical documentation, input administrative notes into various systems, and assist with administrative duties required in the processing of information. The Case Management Team will assist on scheduled Medical Readiness events as needed on weekends when necessary.

This requirement is designed to be flexible, responsive, and meets the ever-evolving needs of the government. DoDI 6025.19 establishes aggressive quarterly and annual metric goals for the separate IMR elements and for the overall IMR category of Fully Medically Ready (FMR) soldiers. The ultimate goals are to produce real-time reports based on complete, accurate data. The Puerto Rico Army National Guard (ARNG) Surgeon’s Office requires a highly responsive process whereby the government can quickly obtain needed support and services. This PWS reflects existing National Guard Bureau policies and regulations.

1.2.2 Medical Credentialing: Medical Credentialing provides coordination of services between Active Duty Medical Treatment Facilities (MTF), Mobilization Sites, State Surgeon Office (SSO), Mobilization Readiness Office (MRO), and Puerto Rico Army National Guard (PR ARNG). Medical Credentialing is managed for Medical, Behavioral Health, and Dental Providers assigned within the PR ARNG. Periodic Inspection ensures all Medical, Behavioral Health and Dental Officers in the state are credentialed. The contractor will ensure all documents are 100% (PSV) Primary Source Verified. Ensures credentialing documents and provider information are uploaded into the (CCQAS) Centralized Credentials Quality Assurance System Provide Human Resources Command (HRC) all credentialing records upon separation with separation order. The goal is for all PRARNG providers to maintain 100% credentialing and privileging throughout the year.

1.3 Period of Performance (PoP): The period of performance shall be one year after contract award.

1.4 General Information:

1.4.1 Quality Control (QC): 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 it is assured that work complies with the requirements of the contract. As the minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary (PRS). A final QCP shall be submitted to the Contracting Officer and Contracting Officer Representative (COR) NLT 10 days after contract award. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

1.4.2 Quality Assurance (QA): The Government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan primarily focuses on what the Government will 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 acceptable quality level(s) or defect rate(s).

1.4.3 Recognized Holidays: The following are recognized United States (US) holidays. The contractor shall not perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King Jr.’s Birthday

1.4.3.3 President’s Day

1.4.3.4 Memorial Day

1.4.3.5 Independence Day: July 4th

1.4.3.6 Labor Day

1.4.3.7 Columbus Day

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day

1.4.3.10 Christmas Day: December 25th

1.4.4 Place and Performance of Services:

1.4.4.1 Case Management: The contractor is responsible for conducting business between the hours of 0700 to 1630, Monday through Friday, during scheduled Medical Readiness Events (MRE) on weekends, except on recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Weekend assistance will be requested in writing to for MRE medical administrative processing of Soldiers through various stations.

Times for weekend assistance will vary, subject to Case Management Team availability. Performance shall be at Building 588,589 Camp Santiago, Salinas 00751

1.4.4.2 Medical Credentialing: The contractor is responsible for conducting business between the hours of 0700 to 1630, Monday through Friday, during scheduled Medical Readiness Events (MRE) on weekends, except on recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Weekend assistance will be requested in writing.

Times for weekend assistance will vary, subject to Deputy State Surgeon Office availability. Performance shall be at Building 588,589 Camp Santiago, Salinas 00751

1.4.4.3 The Contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential. Teleworking is not authorized.

1.4.4.4 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay.

This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.4.5 The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times, and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance.

The Government reserves the right to direct the removal of an employee for misconduct, security reasons, or any overt evidence of communicable disease.

Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

1.4.5 Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DoD), Headquarters Department of Army (HQDA) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.5.1 Contractors will require Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential. CAC issuance requirements are as follows:

In accordance with Department of Defense Manual (DoDM) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. The issuance of a CAC will be based on four criteria: (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 3, 2017, and (d) verification of a claimed identity. Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID System (RAPIDS) using the DD Form 1172-2, or the Trusted Associate Sponsorship System (TASS).

1.4.5.1.1 HSPD-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them, and shall process all CAC card applications. The contractor shall ensure that all employees requiring an initial background investigation complete and submit a Personnel Security Investigation Portal (PSIP) form at Attachment (TBD), at the earliest possible date and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward it to the National Guard Bureau (NGB) Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm that the investigative service provider has received the request, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e-QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the background investigation (BI) will be initiated. The contractor shall ensure immediate compliance with all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from two to six weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that contractor employees meet CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.

1.4.5.1.2 Trusted Associate Sponsorship System (TASS): The contractor shall process CAC applications through the TASS, the procedures for which are described below. Although there is no requirement for the contractor to designate a “Corporate Facility Security Officer" (FSO) to serve as its single point of contact for the BI, the TASS application process and other CAC and security-related matters, such designation facilitates these processes. If an FSO is not established, all contractor employees requiring a CAC will be required to process their own applications. The submission process for CAC applications is as follows:

1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA). The TASS TA for this requirement will be: (TBD)

2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at: https://www.dmdc.osd.mil/tass/. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.

3. The Government will inform the contractor's applicant, via email, of one of the following:

a. Approval.* Upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a RAPIDS station (RAPIDS Site Locator: http://www.dmdc.osd.mil/rsl/).

b. Rejection.* The Government, in separate correspondence, will provide reason(s) for rejection.

c. Return. Additional information or correction to the application required by the contractor employee.

*The contractor shall maintain records of all approved and rejected applications.

1.4.5.1.3 At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification. Identity source documents must come from the list of acceptable documents included in Form I- 9, OMB No. 1615-0047, "Employment Eligibility Verification." Consistent with applicable law, at least one document from the Form I-9 list shall be a valid (unexpired) State or Federal Government-issued picture ID. The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS, and will then issue a CAC. Issued CACs will be valid for no longer than three years, or until the individual's contract end date (inclusive of any options), whichever is earlier.

https://www.dmdc.osd.mil/tass/

1.4.5.1.4 The contractor shall return issued CACs to the DEERS office upon departure or dismissal of each contractor employee, and shall obtain a receipt for each card and provide it to the TA/COR.

1.4.5.1.5 The contractor shall manage requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The contractor shall provide at least 10 calendar days advance notice to the TA, unless there are extenuating circumstances approved by the COR or KO.

1.4.5.1.6 The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a government computer network. This can be done by going to: http://www.us.army.mil and registering as an "Army Guest," with the sponsor being the COR or a COR- designated individual if the COR is ineligible to Serve as an AKO Sponsor. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.

1.4.5.2 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to COMSEC review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DoD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DoD organizations. Therefore, the contractor is advised that any time contractor personnel place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DoD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

1.4.5.3 Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the Army Enterprise Infrastructure (AEI). Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall:

1.4.5.3.1 Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.

http://www.us.army.mil/

1.4.5.3.2 Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil).

1.4.5.3.3 Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.

1.4.5.3.4 Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.

1.4.5.3.5 Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.

1.4.5.4 Protection of Personally Identifiable Information (PII). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

1.4.5.5 AT Level 1 Awareness Training (AT): All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete Level 1 AT within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee to the COR within 15 calendar days after completion of training. Level 1 AT is available at https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf .

1.4.5.6 Information Assurance (IA)/Information Technology (IT) Training: All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.

1.4.5.7 Information Awareness: All contractor employees with access to a government information system shall be registered in the Army Training https://informationassurance.us.army.mil/ https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf

Certification Tracking System (ATCTS) (https://atc.us.army.mil/iastar/index.php) at commencement of services, and shall successfully complete the DoD Information Assurance awareness training prior to access to the IS and then annually thereafter. (https://ia.signal.army.mil/DoDIAA/).

1.4.5.8 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program. This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR within 15 calendar days after completion of training.

1.4.5.9 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training. Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.

1.4.6 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

1.4.6.1 Key Control: All references to keys include key cards. The contractor shall establish and implement methods of ensuring that no keys/key cards issued by the Government are lost or misplaced or are used by unauthorized persons.

No keys issued by the Government shall be duplicated. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the COR.

1.4.6.1.1 In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon direction by the KO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the Government replaces or re-keys the locks, the Government will deduct the total cost of lock replacement or re-keying from the monthly payment due the contractor. In the event a master key is lost or duplicated, the Government will replace all locks and keys for that system, and will deduct the total cost from the monthly payment due the contractor.

1.4.6.1.2 The contactor shall prohibit the use of the Government issued keys/key cards by any persons other than the contractor’s employees. The contractor shall https://atc.us.army.mil/iastar/index.php https://ia.signal.army.mil/DoDIAA/ http://cdsetrain.dtic.mil/opsec/ prohibit the opening of locked areas by contractor employees to permit entrance of persons other than contractor employees engaged in the performance of services in those areas, or personnel authorized entrance by the KO.

1.4.6.2 Lock Combinations: The contractor shall establish and implement methods of ensuring that no lock combinations are revealed to unauthorized persons. The contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations.

1.4.7 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR Subpart 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will apprise the contractor of how the Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.8 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR, to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.9 Identification of Contractor Employees: All contractor 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 that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities. Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed. The contractor shall retrieve all identification media (including vehicle passes) from its employees who depart employment for any reason. The contractor shall return all identification media (i.e., badges and vehicles passes) to the KO within 14 days of an employee’s departure.

1.4.10 Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in any forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.

1.4.11 Contractor Travel: 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 COR recommendation for approval and/or authorization by the KO prior to travel arrangements being made. The contractor may travel to off-site training locations if required by the Government. All travels that are to or less than $500.00 can be approved by COR. If the travel cost is above $500.00 a KO approval is required. The travel approval form in Attachment 1 must be utilized for any travel plans prior to travel. Any location 50 miles or less will not be reimbursed.

1.4.12 Data Rights: The Government has unlimited rights to all documents/materials produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government.

These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.4.13 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5.

The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.4.14 Phase In / Phase Out Periods: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the contractor shall have personnel on board, during the 30 days, phase in/ phase out periods. During the phase in period, the contractor shall become familiar with performance requirements in order to commence full performance of services on the contract start date.

2.0 Definitions and Acronyms:

2.1 Definitions:

2.1.1 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.

2.1.2 Contracting Officer (KO): 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.

2.1.3 Contracting Officer Representative (COR): An employee of the U.S.

Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will 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.

2.1.4 Defective Service: A service output that does not meet the standard of performance associated with the PWS.

2.1.5 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.6 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 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.

2.1.7 Physical Security: Actions that prevent the loss or damage of Government property.

2.1.8 Quality Assurance: The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.9 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements.

2.1.11 Subcontractor: One that enters into a contract with a prime contractor.

The Government does not have privity of contract with the subcontractor.

2.2 Acronyms:

AEI Army Enterprise Infrastructure AFARS Army Federal Acquisition Regulation Supplement AKO Army Knowledge Online AR Army Regulation ARNG Army National Guard AT Awareness Training AT/OPSEC Antiterrorism/Operational Security AUP Acceptable Use Policy BBP Best Business Practices BHCMT Behavioral Health Case Management Team BI Background Investigation CAC Common Access Card CCQAS Centralized Credentials Quality Assurance System CFP/M/E Contractor Furnished Property, Materials, and Equipment CFR Code of Federal Regulations CM Contract Manager CMRA Contractor Manpower Reporting Application CAN Certified Nurse’s Assistant COMSEC Communications Security CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf DA Department of the Army DD250 Department of Defense Form 250 (Receiving Report)

DD254

Department of Defense Contract Security Classification Specification

DEERS Defense Enrollment Eligibility Reporting System DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense DoDI Department of Defense Instruction DSS Deputy State Surgeon DTM Directive Type Memorandum e-QUIP Electronic Questionnaires for Investigations Processing FAR Federal Acquisition Regulation FMR Fully Medically Ready FSO Facility Security Officer FY Fiscal Year

GFP/M/E/S

Government Furnished Property/Material/Equipment/Services

HIPAA Health Insurance Portability and Accountability Act of 1996 HQDA Headquarters, Department of the Army HRR Health Readiness Record HSPD Homeland Security Presidential Directive IA Information Assurance ICTB Interfacility Credentials Transfer Brief IMR Individual Medical Readiness IS Information System(s) JTR Joint Travel Registration KO Contracting Officer

MEDCHART

Medical Electronic Data Care History And Readiness Tracking System

MHS Military Health System MM Medical Management MRNCO Medical Readiness Non Commissioned Officer NACI National Agency Check with Inquiries

NARSUM

NCCMT

Narrative Summaries Non-Clinical Case Management Team

NCQA National Committee for Quality Assurance NGB National Guard Bureau OCI Organizational Conflict of Interest OCMO Office of the Chief Medical Officer ODC Other Direct Costs OPM Office of Personnel Management OPSEC Operational Security PHMMD Population Health and Medical Management Division PII Personally Identifiable Information PIPO Phase In/Phase Out PIV Personal Identity Verification POC Point of Contact PoP Period of Performance PRS Performance Requirements Summary PSIP Personnel Security Investigation Portal

PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program RAPIDS Real-Time Automated Personnel Identification System SRP Soldier Readiness Processing

SSMO

SSN

State STR Management Office Social Security Number

STR Soldier Treatment Record TA Trusted Agent TASS Trusted Associate Sponsorship System TE Technical Exhibit TMA TRICARE Management Activity PR ARNG Puerto Rico Army National Guard UM Utilization Management URAC Utilization Review Accreditation Commission USD(I) Under Secretary of Defense for Intelligence

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S): The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1 Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include desk space, telephones, computers and other items necessary to maintain an office environment.

3.2 Materials: office supplies

3.3 Equipment: None

3.4 Services: None

3.5 Utilities: All utilities in the facility will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.1 General: Except for those items specifically stated to be Government- Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

5.0 Requirements:

5.1 Case Management: The Contractor shall:

5.1.1 Provide Medical and Dental Non-clinical Case Management. The Non- Clinical Case Management Team (NCCMT) consists of the 3 Case Managers and 9 Care Coordinator. Case Management knowledge domains consist of assessment, planning, implementation, coordination, reporting, monitoring and evaluations of the options and services required to meet the ARNG Soldier’s health and human service’s needs. Key personnel are required for service as Case Manager(s) and Care Coordinator(s). One Case manager will be designated as Lead and one Care Coordinator will be designated as Lead.

5.1.2 Review individual Soldier medical information in order to ascertain the medical status of injuries, illnesses, or diseases. The contractor shall not determine the medical or dental fitness of an individual or group. The contractor shall review materials collected and advise DSS and command on the medical status of Soldiers.

5.1.3 Monitor and input information into Medical Operational Data System (MODS) that is an integrated automation system that supports all phases of Human Resource Life-Cycle Management in both peacetime and mobilization.

5.1.4 Facilitate the medical readiness of the Army National Guard (ARNG) by providing web-based services creating and tracking requests for medical services through RHRP program, additionally, support the PDHRA/DHAP program for mass event creation.

5.1.5 Review and report dental status on Dental Classification (DenClass) module used to electronically document the dental readiness with the Medical Operational Data System (MODS) architecture. Assist in the creation and tracking of all elements of a dental examination including: The Soldier’s health history, SF 603A, the dental treatment plan, and a digital repository for dental radiographs.

5.1.6 Review the Electronic Case Management (eCase) module. Open, track, and report provider determinations concerning the disposition of medical cases for Army National Guard Soldiers. Through eCase module provide an automated case-management workflow and task-management system that provides an integrated view of all related data that is obtained from other medical management systems.

5.1.7 Review entries into the Electronic Medical Management Processing System (eMMPS) module used by Army National Guard. Report on the status, provide documentation when needed, and work with agencies to complete requests for, Incapacitation Pay Claim (INCAP) cases, Post-Deployment Health Re- Assessment (PDHRA) referrals, Military Medical Support Office (MMSO) now known as the Defense Health Agency, Great Lakes (DHA-GL) Pre-Authorization cases, and Active Duty Orders Process (ADOP) cases.

5.1.8 Review and submit documentation into the Health Readiness Record (HRR) module provides the ARNG with a web-based repository for Soldier medical, dental, and medical personnel action documentation. Soldier records include non-sensitive, sensitive, and behavioral health documents. Collected medical documentation provided by various entities to include, but are not limited to the individual Soldier, unit, Medical Readiness NCO (MRNCO), Medical Treatment Facility, and Primary Care Physician.

5.1.9 Review and submit entries into the Medical Action Tracking System (MATS), a web-based, workflow module for authorized users which manages medical waiver requests, General Officer Physicals, and Convalescent Leave requests. The module is an electronic means of submission, receipt, storage, processing, and tracking of the medical actions and waivers from Soldiers, Recruiting and Retention Managers (RRMs), and Military Entrance Processing Stations (MEPS) to the Clinical Section of the Army National Guard (ARNG) Surgeon’s Office.

5.1.10 Review and submit information into Reserve Component Automation Systems (RCAS), Mobilization Planning Data Viewer (MPDV) is the system within RCAS used in managing mobilization, safety, personnel and force authorization.

5.1.11 Utilize the Armed Forces Health Longitudinal Technology Application (AHLTA), the military’s electronic health record, a clinical information system that generates, maintains, stores, and provides secure electronic access to comprehensive patient records. The system is used by the active components of the Army, Navy, and Air Force Military Treatment Facilities (MTF).

5.1.12 Responsible for tracking medical status of ALL assigned Soldiers.

5.1.13 Responsible for medical charting in MEDCHART

5.1.14 Request medical documentation from Soldier, Medical Treatment Facility, Medical Providers, and other resources associated with SM medical care.

5.1.15 Track Soldier treatment plans with appropriate medical facilities.

5.1.16 Maintain automated referrals indicated in MEDCHART.

5.1.17 Submit case processing, medical documentation, and profile concerns to military/contacted provider.

5.1.18 Attend Medical Readiness Event (MRE) as determined by the needs for the state and the individual units.

5.1.19 Ensure those Soldiers under managed care from identification of condition to when the Soldier is either:

- Considered medically ready.

- Administratively separated from the military.

5.1.20 Follow the regulations and policies applicable to Individual Medical Readiness (IMR) and deployment.

5.1.21 Report medical readiness to the MRNCO, Commander or designated representative to include Dental Readiness (DRC3 and DRC4) and Medical Readiness Deployability (MRC3, MRC4-PHA, and HIV/IMR/IMM) requirements.

5.1.22 Ensure all medical documentation received from the Soldier, unit, or medical provider is placed in appropriate electronic record, as well as the Soldiers Treatment Record (STR).

5.1.23 Maintain STRs in accordance with Army Regulation (AR) 40-66.

5.1.24 Obtain release of information from Soldier.

5.1.25 Educate Soldiers on resources available to improve medical and dental readiness.

5.1.26 Maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines.

5.1.27 Review and track health assessment (MRE) lab results, contact SM and educate on lifestyle modifications.

5.1.28 Upload medical documents of case management Soldiers into HRR.

5.1.29 Upon request stamp all medical documents for verification after uploading.

5.1.30 Index and validate documents uploaded into HRR.

5.1.31 Upload information into MODS, enter immunizations, designation of pregnancy, eye exams, lab results, and medical warning tags.

5.1.32 Provide all medical documents received for case management to Records Custodian. Assist with the process of filing medical records into individual Soldiers STR. If a document evidence transfer is requested. Copy of each supporting transfer document shall be provided to the COR at the end of each month no later than 7 calendar days at the end of the month.

5.1.33 Ensure that all administrative charting in MEDCHART is completed.

5.1.34 Track medical appointments by communicating with unit to ensure Soldier attendance and submission of follow up documentation. Chart appointment attendance and relay information to the appropriate offices upon request.

5.1.35 Log into MEDCHART any significant contact with SM (email, voice mail, or personal interview).

5.1.36 Run MEDPROS report post MRE. Supply copy to HSS and MRNCO assigned to unit. Monitor MEDPROS to ensure all scheduled services are completed/updated and current medical status is reflected.

5.1.37 Communicate with delegated government personnel to track compliance versus noncompliance.

5.1.38 Ensure Soldiers duty limitations and/or with T3, T4, P3 or P4 profiles are case managed in MEDCHART.

5.1.39 Case Managers shall review medical documentation and prepare Narrative Summary prior to submission to the State Surgeon’s Office for clinical decisions.

5.1.40 Case Managers shall facilitate the ongoing planning, implementation, and evaluation of Soldiers’ clinical cases in the Medical Management Process, to include Soldiers identified for Reserve Component Managed Care (RCMC).

5.1.41 NCCMT shall initiate a case in MEDCHART upon

- Disclosure of duty limiting condition

- SM is initiated into a medical board

- SM requests ADOP

- SM is command directed for services

5.1.42 NCCMT shall update assigned MEDCHART cases one per month

5.1.43 NCCMT shall conduct a case review with MRNCO, HSS, BHCMT, and OCC Health input on a bi-monthly basis. Results of the review for individual Soldiers will be cataloged in MEDCHART. NCCMT will forward a copy of the complete results to DSS/HSS for record. Members of the case review should be as follows:

- Case Manager

- Care Coordinator

- HSS

- BHCMT

- MRNCO

- OCC Health (upon request)

5.1.44 NCCMT shall notify MRNCO upon detection/notification of duty limiting conditions that may require an LOD. NCCMT shall contact the assigned MRNCO with any issue(s) concerning obtaining documentation from the unit or Soldier. HSS will be notified if there is an issue with obtaining documentation form the MRNCO. Upon completion of LOD NCCMT will notify MRNCO of results.

5.1.45 NCCMT shall work with the MRNCO to obtain documentation for ADOP requests. Case Manager will review the medical documentation presented and forward the received packet to HSS for administrative review and processing.

Upon completion of request the assigned Care Coordinator will update MEDCHART and contact MRNCO with results.

5.1.46 NCCMT shall work with MRNCO to obtain documentation for Medical Boards. Case Manager will work with BHCMT to produce a NARSUM for medical boards. Documentation needed for State Medical Review Board(s) will be presented to HSS for review 5 working days prior to submission to DSS for processing. Medical boards requiring submission electronically will be entered by MRNCO or Care Coordinator, forwarded to HSS for processing, and tracked in MEDCHART.

5.1.47 NCCMT shall assist with SRP/RSSP processing, create tracking mechanism for assigned Soldiers and coordinate with MRNCO for the dissemination of information. Results will be submitted to DSS and appropriate offices for record.

5.1.48 NCCMT shall work closely with BHCMT in order to assist with the collection of medical records, produce NARSUM narratives medical board packets, process profiles for individual Soldiers, track/submit waivers for service, scan & index documentation into HRR.

5.2 Medical Credentialing: the contractor shall:

5.2.1 Provide 1 Case manager for coordination of credentialing services between various entities under the supervision of the State Surgeon Office and within the PRARNG. Credentialing is managed for Medical, Behavioral Health, Dental Providers and Nurse Practitioners assigned to the PRARNG. Ensures all Medical, Behavioral Health, Dental Officers and Nurse Practitioners are credentialed and privileged prior to providing services for the Guard. The contractor will ensure credentialing documents and provider information are uploaded into the (CCQAS) Centralized Credentials Quality Assurance System.

5.2.2 Maintain a provider management reporting/tracking system to include…