Performance Work Statement ELP VA Employee Assistance Program.pdf

Performance Work Statement (PWS)

El Paso VA Health Care System (EPVAHCS)

Employee Assistance Program (EAP)

1. CONTRACTING OFFICER REPRESENTATIVE (COR)

Name: Samuel Robertson

Service: Human Resources Management Service

Address: 5001 N. Piedras Street

Phone number: (915-801-6237

Fax number: (915-564-7966)

E-mail address: Samuel.robertson@va.gov

2. BACKGROUND: The Employee Assistance Program (EAP) service is required to maintain a counseling program for

EPVAHCS employees that will help to maintain and enhance the quality of their lives. The purpose of the EAP is the appropriate prevention, treatment and rehabilitation of employees with alcohol, drug abuse or other biopsychosocial problems that are adversely affecting the employee’s job performance and/or conduct.

Biopsychosocial problems may include physical, emotional, financial, marital, family, legal, or vocational issues.

The EAP contract shall begin work (15) calendar days after contract award and continuing for a base year plus four option years.

3. PERIOD OF PERFORMANCE: The period of performance shall be for one (1) Base years plus (4) four option years.

4. SCOPE:

The contractor shall provide an Employee Assistance Program (EAP) for diagnostic and referral services to an estimated

1250 employees of the El Paso VA Health Care System (EPVAHCS) in accordance with all terms and conditions identified in the contract requirements, clauses and addendums. The EPVAHCS consists of one (1) primary medical center located at 5001 N. Piedras Street, El Paso, Texas with two (5) Community Based Outpatient Clinics (CBOC), one

(1) VA Sleep Center, and one (1) Readjustment Counseling Service (Vet Center Office). Employee Assessment, Counseling and Referral services, as described below will be provided at the contractor's place of business by licensed professionals. Employee Orientation and Supervisory Training services, as described below, will be provided at each of the eight (8) operational sites. The eight (8) EPVAHCS site facilities are located in the areas as follows:

Outpatient Clinic/Hospital

El Paso VA Health Care Center, El Paso, TX

CBOCs

El Paso Eastside CBOC – El Paso TX

Las Cruces CBOC – Las Cruces, NM

Westside CBOC – El Paso, TX

South Central CBOC – El Paso, TX

ELP VA Sleep Center- El Paso, TX

North East CBOC - El Paso, TX

VET CENTERS

El Paso Vet Center – El Paso, TX

5. SPECIFIC TASKS.

The following identified services are required:

• Problem assessment, initial counseling toward identifying and assessing the complexity of personal problems which may affect job performance. Follow-up counseling will be limited to a maximum of eight (8) sessions with

Resources and Referrals per identified problem, per person, per year. In addition, counselors will meet with family members on an as-needed basis.

• Twenty-four (24) hour/day emergency telephone number for immediate professional help. Provider shall forward medical emergency calls to 911 when applicable.

• Employee awareness materials such as brochures, posters, quarterly newsletters, addressing applicable EAP topics.

• Feedback on employee progress to the referring official, as authorized by the employee. The referring official shall receive a verification of attendance upon completion of the program or as requested.

• The contractor shall provide internet website access available for all EPVAHCS employees to provide benefit information. EPVAHCS shall have the option to request changes to the website content as needed.

• The contractor shall provide general services from 8:00 AM to 4:45 PM, Monday through Friday, excluding

Federal holidays. This does not preclude services after the stated hours (e.g., emergency crisis intervention) and there shall be no additional charge for after-hour services.

• Telephonic emergency crisis intervention service shall be available 24 hours per day, 7 days per week.

Emergency appointments shall be available within 24 hours of contact.

• Routine appointments shall be established within 24 hours of initial contact and occur within 3-5 days or at the client’s earliest convenience.

• The contractor shall ensure all personnel performing under this contract are fully qualified and have the requisite state licensure, training and experience to provide the necessary services. The contractor shall provide, upon request of the Contracting Officer (CO) or Contracting Officer Technical Representative (COTR), documentation of qualifications, training and experience, of personnel performing under this contract. Failure to ensure personnel meet the necessary qualifications may be cause for termination of the contract. Qualifications of contractor personnel shall be subject to review by the EPVAHCS Chief of Staff and approved by the EPVAHCS

Director.

• The contractor agrees to assign referrals to appropriate, qualified personnel and will notify the CO or COTR in writing prior to proposed substitutions.

• The contractor shall provide performance survey forms to all employees at the conclusion of counseling services provided. Surveys shall be provided to the COTR in analysis format on a semi-annual basis.

• The contractor shall provide statistical reports on a quarterly basis. The report shall include demographic information, types of service(s) provided as well as reporting anonymous customer feedback survey results. The reports' content shall be at the discretion of Human Resources Management Service (HRMS) and is subject to change.

• The contractor shall issue verification of attendance on all EPVHACS employees referred by other than self or if employee requests leave to attend counseling.

• If requested by the Government, contractor agrees that all personnel performing under this contract shall provide a financial disclosure statement detailing any financial interest in any community treatment facility or other resources to which employees might be referred as a result of counseling under EAP.

• The contractor shall maintain complete, individual case files for all employees referred for assistance, consistent with industry standards. Case files shall be maintained in accordance with the confidentiality requirements of PL

93-282 and the implementing Federal Regulations, section 2.11(n) of 42 CFR Part 2 and PL 93-579 (Privacy Act).

6. GENERAL INFORMATION: This contract does not involve connection of one or more contractor-owned IT devices (such as laptop computer or remote connection from a contractor system) to a VA internal trusted (i.e. non-public) network. Therefore, a Security

Accreditation Package is not required.

• The contractor shall provide all resources necessary to accomplish the tasks and deliverables described in this

Performance of Work Statement (PWS). The contractor will independently provide support services to satisfy the overall operational objectives of EPVAHCS. The primary objective is to provide services and deliverables through performance of employee counseling and assistance services that may be needed by the Department of

Veteran Affairs employees employed at EPVAHCS facilities, to include outlying clinics and locations (CBOC, mobile clinics etc. or equivalent). These services are to be brief, focused, crisis intervention with referral for appropriate treatment.

• Contractor shall identify each person functioning as Key Personnel under this contract. At a minimum, key personnel are defined as the project manager who will interface with the CORs, and a clinician who will be serving in the close proximity of each primary facility location.

• The contractor shall provide, at the request of the Contracting Officer or Contracting Officer’s Representative, documentation of qualifications, training and experience, of personnel performing under this contract. Failure to ensure personnel meet the necessary qualifications may be cause for termination of the contract. Qualifications of contractor personnel shall be subject to review.

• The government will have the right to request the Contractor replace any individual who is determined by the government to be a security risk, has been determined to have violated client confidentiality/privacy, or has been determined to be under the influence of alcohol or drugs or is physically or mentally impaired to the extent that they cannot perform tasks established in this PWS. This determination shall be made within the sole discretion of the Contracting Officer or his/her designee. This determination shall not relieve the Contractor from meeting the performance requirements of this contract.

• 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 ensure appropriate counseling services are being provided. The contractor’s quality control program assures that work complies with the requirement of the contract. A proposed Quality Control Plan shall be submitted with the offeror’s proposal. After acceptance of the quality control plan the contractor shall receive the contracting officer’s acceptance in writing of any proposed change to the QC system. The contractor agrees to an ongoing

Quality Assurance Surveillance Program.

1. The quality control plan shall include an on-going quality improvement program designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, resolve identified problems, and pursue opportunities to improve patient care. The contractor shall implement a case review process which will consist of reviewing ten percent (10%) of cases anonymously including the presenting problems/symptoms, treatment plan including referral, and outcome. Cases reviewed will include a representative from all case types that were seen during the last 12 months. The quality control plan shall also describe how satisfaction surveys will be conducted. The contractor will maintain a record of patient complaints, to include problem/resolution in a retrievable file.

• Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the performance requirements identified in Technical Exhibit 1. The performance requirements are designed to ensure the contractor has performed in accordance with the performance requirements and identify the means by which the Government will monitor the contractor’s performance. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

• Recognized Holidays: Contractor is not required to perform in person services on the following holidays.

New Year’s Day Labor Day

Martin Luther King Jr.’s Birthday Columbus Day

President’s Day Veteran’s Day

Memorial Day Thanksgiving Day

Independence Day Christmas Day

• Hours of Operation: The contractor shall provide general services from 8:00 am to 4:30 pm, Monday-Friday.

Evening hours from 4:30-9:00 pm will be available as needed for evening appointments. This does not preclude the contractor from offering services after the stated hours for emergency intervention or employee convenience;

however, there shall be no additional charge for after-hours service or during federally recognized holidays.

Routine appointments shall be established within 24 hours of initial contact and occur within 3- days or at the client’s earliest convenience.

• Telephonic emergency crisis intervention service shall be available 24 hours per day, 7 days per week.

Emergency appointments shall be available within 24 hours of contact.

• Secure web (online) resources and information and tools available twenty-four (24) hour, seven (7) day per week.

• Security Requirements:

1. Confidentiality: Proper confidentiality should be maintained regarding identifying and personal information of clients and/or family members to include social security numbers, telephone numbers, and interview information. Security will be maintained both physically and with automation equipment.

Ethics and standards of confidentiality will be followed according to industry professional standard of conduct.

2. To ensure employee confidentiality, the contractor shall be monitored by a blind survey procedure during the contract performance period. The contractor will coordinate the dates/times for these training sessions thru the COR.

3. Case Files – Privacy Act: The contractor shall maintain complete, individual case files for all employees referred for assistance, consistent with industry standards. Case files shall be maintained in accordance with the confidentiality requirements of PL 93-282 and the implementing Federal Regulations, section

2.11(n) of 42 CFR Part 2 and PL 93-579 (Privacy Act).

4. Medical records of employees with alcohol and/or drug abuse problems will be protected in accordance with sections 523 and 527 of the Public Health Services Act, 42 U.S.C. 290dd-3 and 290ee-3, which is implemented by 42 CFR, part 2. The counseling records of employees' biopsychosocial problems will be protected in the same manner to ensure confidentiality and will be maintained and disposed of in accordance with applicable VA records control schedules and the General Records Schedule 1.

5. Contractor’s patient records shall be maintained in accordance with all applicable regulations.

• VHA Privacy Awareness:

1. Pursuant to the Veteran Health Administration (VHA) Privacy principles and practices, Contractors shall comply with VA’s privacy, policies, and legal requirements found in this link:

https://www.va.gov/privacy-policy/

2. The contractor must contact the education program manager at 915-564-6100 ext. 7600 to take the following Privacy Awareness Training that meets the requirements of the Health Insurance Portability and Accountability Act (HIPAA), Privacy Rule as determined by VHA, and the VA’s Privacy Training

Monitoring SOP:

a. VA 10176 – VA Privacy and Information Security Awareness Training and Rules of Behavior

b. VA 10203 – Privacy and HIPAA Focused Training

c. VA 3185966 – VHA Mandatory Training for Trainees

d. VA 3192008 – VHA Mandatory Training for Trainees - Refresher

3. In accordance with 45 CFR 164.502(e), the Privacy Rule includes exceptions to the Business Associate standard. This contract and its requirements meet the following exception and does not require a

Business Associate agreement in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a Business Associate agreement is not required for this contract.

• Eligibility for Services: Services shall be provided for all employees located at each health care system and their outlying clinics (CBOC, mobile clinics etc. or equivalent). EAP Services may be made available to immediate family members as needed in assisting the employee per Veterans Health Administration Handbook 5019, paragraph 2b. Immediate family is defined as spouse, children, and step-children. Significant other is defined as https://www.va.gov/privacy-policy/ the individual whom the employee shares a household with and has a significant emotional relationship.

Significant emotional relationship is defined as a relationship similar to that of a spouse.

1. Verification of eligibility will be made by viewing employee identification issued by the health care system, samples of the employee badges will be provided during the contract kick off meeting.

• Employee Transportation: Each employee will be responsible for his/her own transportation to appointments.

• Referrals: Requests for employee assistance program services may be made by the employee (self-referral) and by the Contracting Officer’s Representative (management-directed).

1. Management-directed referrals include those requested by a manager/supervisor, union representative, or member of the facility’s occupational health office and may involve a single employee or a group of employees.

2. The contractor agrees to assign referrals to the appropriate qualified staff as represented in its proposal

• Special Qualifications of Contract Personnel: The contractor shall ensure all personnel performing under this contract:

1. Licensed and/or certified staff for the specialty area required by the inquiry. This includes but is not limited to all applicable state and professional licenses for the specialty concerned.

2. Master’s Degree for Social Worker and PhD for Psychologist

3. Standardized credentialing processes, including maintenance of credentialing records to ensure providers are properly credentialed and privileged to provide necessary services. The credentialing process should verify the provider’s malpractice claims, verification of licensures/certifications, and any

Medicare/Medicaid sanctions.

7. RECORDS MANAGEMENT: The contractor shall comply with the following record management procedures:

1. All records (administrative and program specific) created during the period of the contract belong to EL

Paso Veterans Affairs Health Care System (ELPVAHCS) and must be returned to EL Paso Veterans

Affairs Health Care System (ELPVAHCS) at the end of the contract or destroyed in accordance to the

VHA Record Control Schedule (RCS)10-1.

2. Contractor shall comply with all applicable records management laws and regulations, as well as National

Archives and Records Administration (NARA) records policies, including but not limited to the Federal

Records Act (44 U.S.C. chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C.

552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

3. n accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters

21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy

Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

4. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the

Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

5. ELPVAHCS and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of

ELPVAHCS or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18

U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to ELPVAHCS records officer . The agency must report promptly to

NARA in accordance with 36 CFR 1230.

6. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the contract. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the

Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to ELPVAHCS control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle].

Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

7. The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The

Contractor (and any sub-contractor) is required to abide by Government and ELPVAHCS guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

8. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with ELPVAHCS policy.

9. The Contractor shall not create or maintain any records containing any non-public ELPVAHCS information that are not specifically tied to or authorized by the contract.

10. The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.

11. The ELPVAHCS owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which [Agency] shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-

11 through FAR 52.227-20