Statement Of Work Emergency Medical Services (EMS) Distance Learning

Web Based Interactive Distance Learning for IHS, Tribal, and Urban Programs

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

Emergency Medical Services (EMS) is a system that focuses on treating illnesses and injuries that require an urgent medical response. EMS is an intricate system, and each component of this system has an essential role to perform as part of a coordinated and seamless system of emergency medical care.

Examples of attributes and components of an EMS system include manpower, medical direction, communications, professional training, community education, injury prevention, information systems and evaluation, and rehabilitation. To be most effective, EMS must be fully integrated into the overall health system.

The standards for the daily operations of the EMS program are outlined in Part 3 of the Indian Health Manual, Chapter 17. Major components of an EMS system are emergency response and inter-facility transport. The intent of the system response is to optimize the outcome of the individual(s) involved by minimizing the physical, emotional, and financial impact of the emergency. After stabilization at an initial facility, transport to another facility capable of a more specialized level of care is sometimes necessary.

In general, an EMS response can be Basic Life Support (BLS), Advanced Life Support (ALS), or both depending on the skill level of the available personnel and the needs of the patient. While urban EMS systems provide both BLS and ALS responses in a tiered fashion, rural EMS systems provide primarily BLS responses with limited ALS availability. The efficiency of urban systems is driven by “system status management;” no similar model exists for the management of rural EMS.

In addition to direct patient care duties, EMS personnel are also involved in daily equipment maintenance and restocking when not involved in direct patient care. Due to population density, rural EMS’ are less busy than urban services, and EMS personnel may have periods of time with no patient care contact. EMS personnel, like other public safety entities, are expected to always be available and are paid for readiness. Other activities in which they are appropriately engaged include continuing education, community education (e.g., CPR), injury prevention, assisting in patient care in the Emergency Department setting, and performance improvement. This EMS module assumes that coverage will be available for the entire service area on a full-time, uninterrupted basis 24 hours a day, 7 days a week, 365 days a year (24/7/365).

1.3 Scope

The Indian Health Service Emergency Medical Services systems provide comprehensive, culturally appropriate care for IHS, Tribal, and urban programs. Under this contract, the contractor is responsible for providing culturally appropriate web-based interactive distance learning management system that allows courses to be taught with students and instructors in different locations and requires no travel; validating student skills competencies; and providing courses that meet national certification and recertification requirements and standards of national, state, and accrediting/certifying organizations (including but not limited to Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS), American Safety and Health Institute (ASHI), American Hospital Association (AHA), National Registry of Emergency Medical Technicians (NREMT), etc. The target training population includes: Emergency Medical Technicians (EMTs) and paramedics. Through this approach, IHS will align the training efforts with the IHS Strategic Plan, while promoting the core IHS priorities of people, partnerships, and quality of healthcare services.

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, system-wide training for EMS personnel.

The expectation is that the contractor shall engage in a range of activities that will initiate and solidify all the core training courses that meet national certification and recertification requirements and standards of national, state, and accrediting/certifying organizations.

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 (if applicable). 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 maintain proper and accurate time keeping records of personnel assigned to work on the requirement.

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

The comprehensive action plan (which includes proposed activities for each deliverable, a description of each product, and an estimated timeline with milestones) will be provided within 2 weeks of the contract kick-off meeting and must be approved prior to the initiation of services and activities under this agreement.

2.6 Personnel Administration

The contractor shall 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 SOW requirements. The contractor shall make necessary travel arrangements for employees. The contractor shall provide the necessary infrastructure to support contract tasks.

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

2.7 Subcontract Management

The contractor shall be responsible for any subcontract management necessary to integrate work performed on this requirement and shall be responsible and accountable for subcontractor performance on this requirement. The prime contractor shall 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’s Representative (COR). Cross-teaming may or may not be permitted.

2.8 Contractor Personnel, Disciplines, and Specialties

The contractor shall accomplish the assigned work by employing and utilizing qualified personnel with appropriate combinations of education, training, and experience. All trainers must be approved by the COR. The contractor shall match personnel skills to the work or task with a minimum of under/over employment of resources. The contractor shall 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 (SOW line item) issued hereunder will be the minimum necessary to accomplish the task.

The Contractor shall 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 SOW 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.

The Contractor will be responsible for coordinating the logistics of the trainings to include but not be limited to securing a site (with priority given to Federal facilities) for the trainings, payment of non-federal sites, and on-site and web-based registration services.

2.10 Travel / Temporary Duty (TDY)

No travel is anticipated. 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).

Travel for training participants will not be covered under this contract.

3 Performance Requirements The contractor will be responsible for implementing culturally appropriate web based interactive distance learning management system and coordinating the logistics of the accredited trainings courses that meet national certification and recertification requirements and standards of national, state, and accrediting/certifying organizations.

The period of performance for this task order shall be 12 months from the date of award with two 12-month option periods. All trainings must be completed within the performance period. The contractor will not oversell or pre-sell training services.

The following section specifies 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.

Performance Standards

1) Timely

a. Acceptable Quality Level (AQL): As evidenced by deliverables.

2) Required Report Data

a. AQL: Testing scores for each participant; training instructors’ names and credentials;

participant evaluations of the course and instructors; accounting of all costs incurred;

an overall evaluation of the course and course activities; a listing of the participants which identifies the employer and site of the student and identification of the student’s professional category; verification of the participant’s eligibility (verifying the identified Tribe is eligible for training due to non-acceptance of tribal shares); course statistics including number of participants, number of applicants, number of approved applicants who did not attend training, and number of participants that the training could accommodate. For training courses that require completing and receiving a passing grade on pre-course training modules, the contractor will also include number of participants receiving the pre-course modules, grades of completed pre-course modules, and number of participants who did not complete modules or courses.

3) The Contractor will not oversell or pre-sell training services; all services must be completed within the identified performance period.

a. AQL: As evidenced by deliverable

Deliverables A001 Monthly reports A002 Database A003 Class schedules

3.2 Course Schedule Report

Semi-annually (every 6 months), the contractor, COR, and PM will meet to determine the quarterly course schedule. The agreed quarterly course schedule meeting will occur at least 90 days prior to the start of a course schedule.

a. AQL: According to deliverable schedule

2) Report Data

3) Must provide a quarterly “proposed courses request” to the COR and PM of proposed scheduled training sessions to include topic(s) of training, type of training (i.e. individual or instructor development), audience for training, number of participants that can be accommodated, and course evaluations. The contractor must receive approval of the proposed course report from the COR and PM to proceed with training sessions.

4) COR and PM must approved course, which may include nationally recognized emergency care course for health care providers in the pre-hospital, out of hospital, and hospital settings such as but not limited to, Advance Cardiac Life Support (ACLS), Basic Life Support (BLS), Pediatric Advanced Life Support (PALS), Emergency Pediatric Care (EPC), Pediatric Education for the Pre- Hospital Provider (PEPP), and Advanced Medical Life Support (AMLS).

5) The Contractor will not oversell or pre-sell training services; all services must be completed within the identified performance period.

B001 Proposed Course Requests B002 Approved Course Schedule Reports B003 Registration and attendance rosters

3.3 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.

Deliverables C001 Annual Report

3.4 Participation Database

The contractor will maintain a participant database in a secure environment and provide the COR and PM queries as requested.

a. AQL: Must provide at a minimum: number of participants; number of successful and unsuccessful participants completing training and certification; identification and count of eligible Tribes associated with participants; identification and count of EMS program or health facility where each participant is associated; identification and count of training courses offered including dates of training (at least month and year); number of participants in training courses offered; and training course evaluation data.

D001 Participant Database Summary

3.5 Course Evaluation

For all courses, the contractor will provide student evaluations of each course and individual instructors.

The contractor will provide a draft of the evaluation to the COR and PM for review, comment, and approval before first scheduled training. The Contractor will utilize the evaluation at the end of each course and include a report of the evaluation findings in the monthly reports and a summary report in the quarterly and final reports.

3) Timely

4) Report Data

Deliverables E001 Course and instructor evaluations E002 Registration and attendance rosters E003 Monthly, Quarterly, and Annual Reports

4.1 Cultural Competency

The contractor will ensure that instructors who teach and/or interact with students, Tribes, and tribal personnel communicate in a culturally appropriate and respectful manner. An available resource is: A Guide to Build Cultural Awareness: American Indian and Alaska Native.

Deliverable F001 Roster of instructors F002 Instructor evaluations

4.2 Qualified Instructors/Trainings

The contractor will ensure all instructors meet all state and national certification requirements to teach specialized courses and all EMT training meets state and national certification specifications and requirements for licensure in states where students work.

b. AQL: As evidenced by deliverable

2) Certifications https://store.samhsa.gov/product/American-Indian-and-Alaska-Native-Culture-Card/sma08-4354 https://store.samhsa.gov/product/American-Indian-and-Alaska-Native-Culture-Card/sma08-4354

Deliverable G001 Certifications of instructors G002 Course certifications

5.1 Training Management System

The contractor will develop and implement a secure web based interactive distance learning management system that meets all identified requirements.

a. AQL: As evidence by deliverable

2) Interactive Training

a. AQL: Requires no instructor or student travel; real time training and interaction;

provide training materials and equipment for students; meets certification and re-certification requirements and national, state, and accrediting/certifying organizations;

provide continuing education units/credits; training must be completed within the identified performance period.

b. The contractor will provide training to (up to) 250 EMTs and paramedics annually.

c. Training session are defined as one or more training topic for each certification or re-certification course.

d. The contractor will provide technical assistance to the participants as needed.

e. The contractor will provide recommendations for future trainings to address patient needs.

f. The contractor shall incorporate interactive learning strategies such as case-based scenarios, real time polling, facilitated discussion, or problem solving exercises to promote participant engagement and reinforce application of clinical concepts in EMS practice.

3) Evaluations

a. AQL: See 3.5 for specifics

4) Credentialing

a. AQL: The contractor will provide completion documentation to students for course requirements in the state in which they reside, including certification from a nationally recognized certifying organization.

b. The contractor will send all correspondence notifying applicants of the status for training within 14 days and respond to all questions from participants related to training in a timely manner.

c. Where appropriate, the contractor will provide clear instructions to participants regarding the completion of the modules and review and grade participants’ completed modules.

5) Database

a. AQL: See 3.4 for specifics

H001 Course list H002 Registration and attendance rosters H003 Completed certification list H004 Course and instructor evaluations H005 Evaluation report of successes, challenges, and needs related to technical assistance H006 Monthly, Quarterly, and Annual Reports H007 Participant Database Summary

5.2 Eligibility

The contractor will make training available to eligible IHS, Tribal, and urban staff.

2) Eligibility Requirements

a. AQL: The contractor will cover the registration fee, training costs, Webex, video conferencing, and teleconferencing.

b. IHS COR and PM will provide the contractor with a user list of healthcare providers who will receive training under this contract. The contractor must allow for IHS, Tribal, and urban programs health care providers not included in the user list to pay for training at the same rate covered under this contract.

I001 Registration and attendance roster

5.3 Technical Assistance

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

J001 Technical assistance summary

6.1 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.

6.2 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.

6.3 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.

6.4 Website Development

At a minimum, the information on the website shall provide: the capability for online training registration, the training flyers, announcements, and communications materials for trainings, information on CEU/CME credits, and other information deemed necessary by the COR. All web-based materials, including curriculum content, presentations, webinars, etc., must be 508-compliant. Website finalization requires approval by the COR.

6.5 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. Training updates and correspondence include but are not limited to training summaries, conference call agendas and minutes, and any other items deemed necessary by the COR.

6.6 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.

6.7 Deliverables Table

2.5 Contract Administration

Deliverable Timeframe

Kick-Off Meeting Meeting 30 days after contract awarded

Comprehensive Action Plan, Quality Assurance

Plan, Communications Plan, Evaluation Plan, and

Project Plan

Action Plans 2 weeks after the kick-off meeting

3. Project Management and Reporting Deliverable Timeframe

3.1 Monthly Report of Activities Report (written) Monthly

3.2 Course Schedule Report Report (written) Semi-Annual (every 6 months)

3.3 Annual Report on Project (written) Final Report (written) 30 days prior to the conclusion of the contract year

3.4 Participant Database Database 2 weeks prior to the first

training

3.5 Develop evaluation instruments for each

course and individual instructors

Evaluation form Before 1st scheduled training session

4. Faculty and Curriculum Deliverable Timeframe

4.1 Select instructors that communicate in a

culturally appropriate and respectful manner.

Qualified instructors As agreed in the action plan

4.2 Utilize qualified healthcare professionals Qualified instructors As agreed in the action plan

5. Training and Meeting Logistics Deliverable Timeframe

5.1 Develop and implement a secure web-based

interactive distance learning management system that meets all identified requirements.

Training Management

System

3 months after the kick-off meeting

5.2 Receive and Review the list of Tribes who may

receive training at no cost, and those who must pay a fee for their students will be identified for training paid for to the contractor.

IHS List of Tribes Semi-Annual (every 6 months) with Course Schedule Report

5.3 Respond to all questions from IHS and Tribal

EMS programs and EDs related to training in a timely manner.

Technical Assistance As agreed in the work plan