SOW_IHS_CNCD_CancerNavigation.pdf

Statement of Work Cancer Naviga�on Curriculum Development

January 25, 2024

I. Background Cancer navigation services offered through the healthcare system are known to improve breast, colorectal, and cervical cancer screenings (Genoff, 2016). Despite advances in early detection, the poor and minority populations are not accessing screening services, which may result in poor survival outcomes (Neal, 2018). Lack of transportation, living in a rural geographical location, not being aware of the importance of routine preventive screenings, and other barriers may impede access to screening and treatment services. American Indian and Alaska Native people continue to experience late-stage diagnoses, which often lead to poor cancer outcomes.

Patient navigators can facilitate trusting relationships to overcome potential issues such as distrust in providers and avoidance of the healthcare system (Natale-Pereira, 2011). Language barriers and low health literacy affect people from all facets of life. Limited health literacy is associated with less use of preventive services such as mammography and cancer screenings and less controlled management of chronic conditions like diabetes and high blood pressure (Fiscella, 2002). To address the complexity of the healthcare system, navigators can reduce barriers, bridge gaps in services, provide culturally appropriate educational outreach using their Native language to communicate the importance of early detection and screening, provide follow-up with patients with abnormal results, and help patients navigate and coordinate care with cancer treatment centers.

The problem: Low cancer screening, early detection, and prolonged time to treatment lead to poor survival among American Indian and Alaska Native people. Cancer navigation services have improved screening outcomes among the general population; however, there are limited or no published studies replicating cancer patient navigation programs among the AI/AN population to enhance screenings.

II. Purpose The Indian Health Service proposes to develop culturally adapted cancer navigation training to improve preventive screening, link patients with abnormal results back to appropriate resources, and help with cancer treatment care coordination.

III. Period of Performance

The period of performance shall be 6 months from effective date of contract.

IV. Tasks The Contractor shall provide the personnel and services to perform the below tasks. The tasks will be performed during the period of the contract unless otherwise specified

Task 1: Project Management

1.1 Meet and electronically communicate with COR and Program Office, and the IHS. Team to discuss and review curriculum content, provide edits, and develop final curriculum in electronic and hardcopy formats.

1.2 Develop the training component of the patient navigation curriculum to include content, sequence, timing, and handout materials. Conduct a small focus group with Cancer Coordinators, Cancer Care Takers, and Stake holders to go over the Curriculum and edit it.

1.3 Conduct training with I.H.S. key personnel at the pilot test site(s) to be identified by I.H.S

1.4 Evaluate the pilot project using outcomes measures and revise the final curriculum as needed and submit the final product by Aug 31, 2024.

1.5. Distribute the final Cancer Navigation Curriculum to other American Indian and Alaskan Native communities. Contractor to provide an effective and engaging Cancer Navigation Curriculum Program and conduct up to 3 in-person train-the-trainer trainings on the Navajo Nation from March 1, 2024- August 31, 2024. The curriculum will focus on American Indian and Alaskan Native cancer and survivorship journey and have modules focused on Care Coordination (Patient Navigation), Communication and Collaboration, Basic Cancer Information, Education and Evidence-Based Information, and Professional Roles of a Patient Navigator.

Task 2: Prepare detailed workplan, output, objectives, and timeline of implementation

2.2: Preparatory meetings in coordination with IHS, partners and access sites

2.3: Analysis on Patient Navigation programs on partner sites, through interviews and literature review.

2.4: Monthly meeting updates with HIS Patient Navigation Work Team and meet with a small team to go over (Focus Group) with Cancer Coordinators, Caregivers, and stakeholder.

Task 3:Development of Curriculum

Develop a pilot curriculum and training program on Patient Navigation based on current evidence and best practices that will serve to assist trainers with the following scope: (a) knowledge about the disease,

(b) knowledge about the linkages with the hospital care team, (c) knowledge about the community referral system, and (d) knowledge about professional skills to be a navigator.

3.1: Pilot curriculum on patient navigation for cancer, covering the aforementioned scope.

3.2: Pilot training plan on the delivery of the patient navigation curriculum

Task 4:Implement the training

4.1: Implement Training to at least 5 or more personnel who will serve as patient navigators (in-person training)

4.2: Identification of access sites with existing patient navigators (institutions/hospitals that are designated cancer centers service) to establish referral system

4.3: At least five personnel trained in the patient navigation curriculum per partner access site.

PARTICIPANT SITES CITY/STATE DATE Descrip�on

TBD AZ TBD Train the Trainer

4.4: Report on the acceptability, adoptability, appropriateness of Patient Navigation curriculum (assessed after the training and within two months of service)

4.5: Develop an evaluation survey on the satisfaction of patients and families who were assisted by trained navigators to be implemented by the I.H.S. Patient Navigation Workgroup team.

4:6: Develop and evaluation form to document the satisfaction of doctors and the medical team who were assisted by trained navigators to be implemented by the I.H.S. Patient Navigation Workgroup team.

TASK 5: Identify potential challenges and difficulties in the implementation of the Patient Navigation curriculum and training program among pilot cancer centers and describe the potential sustainability issues and cost of a wider-scale implementation of the Patient Navigation curriculum and training program.

5.1: Report on potential implementation challenges, sustainability issues, and cost of wider-scale implementation of Training Curriculum.

5.2: Final curriculum on patient navigation for cancer

Task 6: Technical narrative reports and financial statements.

6.1: Store all project materials (minutes of meetings, photos, references, etc.) on a flash drive and backed up in an appropriate cloud server.

6.2: Submission of the final technical narrative report that includes project implementation and financial report.

V. Deliverables

VI. Task Deliverable Medium and Format

Submit to Due Date

Task 1. Host Kickoff Meeting Task 1.1 Kickoff Meeting agenda DOC or PDF;

email

IHS/HQ &

COR

Five (5) business days before scheduled kick off meeting

Task 1.4 Meeting notes to the COR and TBHCE leadership for review and comment

DOC or PDF;

email

Leadership &

COR

Three (3) business days following the kickoff meeting

Task 1.5 Final meeting notes to the COR and TBHCE leadership

DOC or PDF;

email

Leadership &

COR

Two (2) business days after receipt of comments from

TBHCE

Leadership &

COR

Task 2: Contractor Meetings Task 2.3 Meeting DOC or PDF;

email Leadership &

COR

Five (5) business days before each scheduled meeting

Task 3: Develop the curriculum Task 3.1 Develop the curriculum Must be submitted electronically by email.

Leadership and

COR

Schedule will be discussed at Kickoff meeting & content

PowerPoint Slides (course entirety) and any associated handouts, training materials, (PDF) planning meetings

Task 3.2 Develop the curriculum and Pilot the Curriculum

PPT, handouts, and electronic

Leadership &

COR

Schedule will be discussed at Kickoff meeting & content planning meetings

Task 4: Implement the Training Task 4.1 Implement training at Site DOC or PDF;

email Leadership &

COR

Compiled and included with every Report.

Task 5: Identify challenges or edits in the curriculum

5.1 Document and edit

information of the curriculum. Adapt curriculum changes to the curriculum

DOC, PDF,

EMAIL

Leadership &

COR

TBD

5.2 Finalize Curriculum based

on the recommendations and outcomes of the Training

DOC, PDF,

EMAIL

Leadership &

COR

TBD

Task 6: Storage of Technical Narratives, reports, and financial statements.

Task 6.1 Store all curriculum on

TEAM, Cloud on compatible hard drives

Take 6.2 Submit curriculum, narrative, and financial reports.

Task 7: Basic Security Requirements

1) Applicability. The requirements herein apply whether the en�re contract or order (herea�er “contract”), or por�on thereof, includes either or both of the following:

a. Access (Physical or Logical) to Government Informa�on: A Contractor (and/or any subcontractor) employee will have or will be given the ability to have, rou�ne physical (entry) or logical (electronic) access to government informa�on.

b. Operate a Federal System Containing Informa�on: A Contractor (and/or any subcontractor) will operate a federal system and informa�on technology containing data that supports the

HHS mission. In addi�on to the Federal Acquisi�on Regula�on (FAR) Subpart 2.1 defini�on of “informa�on technology” (IT), the term as used in this sec�on includes computers, ancillary equipment (including imaging peripherals, input, output, and storage devices necessary for security and surveillance), peripheral equipment designed to be controlled by the central processing unit of a computer, so�ware, firmware and similar procedures, services (including support services), and related resources.

2) Safeguarding Informa�on and Informa�on Systems. In accordance with the Federal Informa�on Processing Standards Publica�on (FIPS)199, Standards for Security Categorization of Federal Information and Information Systems, the Contractor (and/or any subcontractor) shall:

a. Protect government informa�on and informa�on systems in order to ensure:

• Confiden�ality, which means preserving authorized restric�ons on access and disclosure, based on the security terms found in this contract, including means for protec�ng personal privacy and proprietary informa�on;

• Integrity, which means guarding against improper informa�on modifica�on or destruc�on, and ensuring informa�on non-repudia�on and authen�city; and

• Availability, which means ensuring �mely and reliable access to and use of informa�on.

b. Provide security for any Contractor systems, and informa�on contained therein, connected to an HHS network or operated by the Contractor on behalf of HHS regardless of loca�on. In addi�on, if new or unan�cipated threats or hazards are discovered by either the agency or contractor, or if exis�ng safeguards have ceased to func�on, the discoverer shall immediately, within one (1) hour or less, bring the situa�on to the aten�on of the other party.

c. Adopt and implement the policies, procedures, controls, and standards required by the HHS Informa�on Security Program to ensure the confiden�ality, integrity, and availability of government informa�on and government informa�on systems for which the Contractor is responsible under this contract or to which the Contractor may otherwise have access under this contract. Obtain the HHS Informa�on Security Program security requirements, outlined in the HHS Informa�on Security and Privacy Policy (IS2P), by contac�ng the CO/COR or emailing fisma@hhs.gov.

d. Comply with the Privacy Act requirements.

3) Protec�on of Sensi�ve Informa�on. For security purposes, informa�on is or may be sensi�ve because it requires security to protect its confiden�ality, integrity, and/or availability. The Contractor (and/or any subcontractor) shall protect all government informa�on that is or may be sensi�ve in accordance with OMB Memorandum M-06-16, Protection of Sensitive Agency Information by securing it with a FIPS 140-2 validated solu�on.

See the HHS Standard for the Definition of Sensitive Information, for additional information in defining and protecting sensitive information.

4) Confiden�ality and Nondisclosure of Informa�on. Any informa�on provided to the contractor (and/or any subcontractor) by HHS or collected by the contractor on behalf of HHS shall be used only for the purpose of carrying out the provisions of this contract and shall not be disclosed or made known in any manner to any persons except as may be necessary in the performance of the contract. The Contractor assumes responsibility for protec�on of the confiden�ality of Government records and shall ensure that all work performed by its employees and subcontractors shall be under the supervision of the Contractor. Each Contractor officer or employee or any of its subcontractors to whom any HHS records may be made available or disclosed shall be no�fied in wri�ng by the Contractor that informa�on disclosed to such officer or employee can be used only for that purpose and to the extent authorized herein.

The confiden�ality, integrity, and availability of such informa�on shall be protected in accordance with HHS and HRSA policies. Unauthorized disclosure of informa�on will be subject to the HHS/HRSA sanc�on policies and/or governed by the following laws and regula�ons:

a. 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records);

b. 18 U.S.C. 1905 (Criminal Code: Disclosure of Confiden�al Informa�on); and

c. 44 U.S.C. Chapter 35, Subchapter I (Paperwork Reduc�on Act).

5) Contractor Non-Disclosure Agreement (NDA). If applicable, each Contractor (and/or any subcontractor) employee having access to non-public government informa�on under this contract shall complete the HRSA non-disclosure agreement. A copy of each signed and witnessed NDA shall be submited to the Contrac�ng Officer (CO) and/or CO Representa�ve (COR) prior to performing any work under this acquisi�on.

Training

(https://www.hhs.gov/about/agencies/asa/ocio/cybersecurity/security-awareness-training/index.html)

1) Mandatory Training for All Contractor Staff. All Contractor (and/or any subcontractor) employees assigned to work on this contract shall complete the applicable HHS/IHS Contractor Informa�on Security Awareness, Privacy, and Records Management training (provided upon contract award) before performing any work under this contract. Therea�er, the employees shall complete HHS/IHS Informa�on Security Awareness, Privacy, and Records Management training at least annually, during the life of this contract. All provided training shall be compliant with HHS training policies.

https://www.hhs.gov/about/agencies/asa/ocio/cybersecurity/security-awareness-training/index.html https://www.hhs.gov/about/agencies/asa/ocio/cybersecurity/security-awareness-training/index.html

2) Role-based Training. All Contractor (and/or any subcontractor) employees with significant security responsibili�es (as determined by the program manager) must complete role-based training annually commensurate with their role and responsibili�es in accordance with HHS policy and the HHS Role-Based Training (RBT) of Personnel with Significant Security Responsibilities Memorandum.

3) Training Records. The Contractor (and/or any subcontractor) shall maintain training records for all its employees working under this contract in accordance with HHS policy. The training records shall be provided to the CO and/or COR within 30 days a�er contract award and annually therea�er or upon request.

Rules of Behavior

1) The Contractor (and/or any subcontractor) shall ensure that all employees performing on the contract comply with the HHS Information Technology General Rules of Behavior, the IHS Informa�on Technology Rules of Behavior (included in the IHS Informa�on Security and Privacy Awareness Training), and any applicable system-level rules of behavior.

2) All Contractor employees performing on the contract must read and adhere to the Rules of Behavior before accessing Department data or other informa�on, systems, and/or networks that store/process government informa�on, ini�ally at the beginning of the contract and at least annually therea�er, which may be done as part of annual IHS Informa�on Security Awareness Training. If the training is provided by the contractor, the signed ROB must be provided as a separate deliverable.

Incident Response

FISMA defines an incident as “an occurrence that (1) actually or imminently jeopardizes, without lawful authority, the integrity, confiden�ality, or availability of informa�on or an informa�on system; or (2) cons�tutes a viola�on or imminent threat of viola�on of law, security policies, security procedures, or acceptable use policies. The HHS Policy for IT Security and Privacy Incident Reporting and Response further defines incidents as events involving cybersecurity and privacy threats, such as viruses, malicious user ac�vity, loss of, unauthorized disclosure or destruc�on of data, and so on.

A privacy breach is a type of incident and is defined by Federal Informa�on Security Moderniza�on Act (FISMA) as the loss of control, compromise, unauthorized disclosure, unauthorized acquisi�on, or any similar occurrence where (1) a person other than an authorized user accesses or poten�ally accesses personally iden�fiable informa�on or (2) an authorized user accesses or poten�ally accesses personally iden�fiable informa�on for an other than authorized purpose. The HHS Policy for IT Security and Privacy Incident Reporting and Response further defines a breach as “a suspected or confirmed incident involving PII”.

In the event of a suspected or confirmed incident or breach, the Contractor (and/or any subcontractor), the Contractor (and/or any subcontractor) shall:

1) Protect all sensi�ve informa�on, including any PII created, stored, or transmited in the performance of this contract so as to avoid a secondary sensi�ve informa�on incident with FIPS 140-2 validated encryp�on.

2) NOT no�fy affected individuals unless so instructed by the Contrac�ng Officer or designated representa�ve. If so instructed by the Contrac�ng Officer or representa�ve, the Contractor shall send no�fica�ons to affected individuals as expedi�ously as prac�cable, without unreasonable delay, and in accordance with applicable law.

3) Report all suspected and confirmed informa�on security and privacy incidents and breaches to the IHS Security Opera�ons Center (SOC), COR, CO, IHS SOP (or his or her designee), and other stakeholders, including incidents involving PII, in any medium or form, including paper, oral, or electronic, as soon as possible and without unreasonable delay, no later than one (1) hour, and consistent with the applicable IHS and HHS policy and procedures, NIST standards and guidelines, as well as US-CERT no�fica�on guidelines. The types of informa�on required in an incident report must include at a minimum: company and point of contact informa�on, contact informa�on, impact classifica�ons/threat vector, and the type of informa�on compromised. In addi�on, the Contractor shall:

a. cooperate and exchange any informa�on, as determined by the Agency, necessary to effec�vely manage or mi�gate a suspected or confirmed breach;

b. not include any sensi�ve informa�on in the subject or body of any repor�ng e-mail; and

c. encrypt sensi�ve informa�on in atachments to email, media, etc.

4) Comply with OMB M-17-12, Preparing for and Responding to a Breach of Personally Identifiable Information, HHS, and IHS incident response policies when handling PII breaches.

5) Provide full access and cooperate on all ac�vi�es as determined by the Government to ensure an effec�ve incident response, including providing all requested images, log files, and event informa�on to facilitate rapid resolu�on of sensi�ve informa�on incidents. This may involve disconnec�ng the system processing, storing, or transmi�ng the sensi�ve informa�on from the Internet or other networks or applying addi�onal security controls.

Position Sensitivity Designations

When applicable all Contractor (and/or any subcontractor) employees must obtain a background inves�ga�on commensurate with their posi�on sensi�vity designa�on that complies with Parts

1400 and 731 of Title 5, Code of Federal Regula�ons (CFR). The following posi�on sensi�vity designa�on levels apply to this solicita�on/contract:

The requiring activity representative, in conjunction with Personnel Security, shall use the OPM Position Sensitivity Designation automated tool (https://www.opm.gov/investigations/) to determine the sensitivity designation for background investigations. After making those determinations, include all applicable position sensitivity designations.

Homeland Security Presidential Directive (HSPD)-12 The Contractor (and/or any subcontractor) and its employees shall comply with Homeland Security Presidential Directive (HSPD)-12, Policy for a Common Identification Standard for Federal Employees and Contractors; OMB M-05-24; FIPS 201, Personal Identity Verification (PIV) of Federal Employees and Contractors; HHS HSPD-12 policy; and Executive Order 13467, Part 1 §1.2.

For additional information, see HSPD-12 policy at: htps://www.dhs.gov/homeland-security-presiden�al-direc�ve-12)

Roster. The Contractor (and/or any subcontractor) shall submit a roster by name, posi�on, e-mail address, phone number and responsibility, of all staff working under this acquisi�on where the Contractor will develop, have the ability to access, or host and/or maintain a government informa�on system(s). The roster shall be submited to the COR, with a copy to the Contrac�ng Officer, within 14 days of the effec�ve date of this contract. Any revisions to the roster as a result of staffing changes shall be submited within 14 days of the change. The COR will no�fy the Contractor of the appropriate level of inves�ga�on required for each staff member.

If the employee is filling a new posi�on, the Contractor shall provide a posi�on descrip�on and the Government will determine the appropriate suitability level.

Contract Initiation and Expiration

1) General Security Requirements. The Contractor (and/or any subcontractor) shall comply with informa�on security and privacy requirements, to ensure informa�on is appropriately protected from ini�a�on to expira�on of the contract. All informa�on systems development or enhancement tasks supported by the contractor shall follow the IHS informa�on security requirement and processes, in accordance with the HHS Contract Closeout Direc�ve (2018).

HHS EA requirements may be located here:

htps://www.hhs.gov/ocio/ea/documents/proplans.html https://www.opm.gov/investigations/ https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.dhs.gov/homeland-security-presidential-directive-12

2) System Documenta�on. Contractors (and/or any subcontractors) must follow and adhere to

NIST SP 800-64, Security Considerations in the System Development Life Cycle, at a minimum, for system development and provide system documenta�on at designated intervals (specifically, at the expira�on of the contract) within the EPLC that require ar�fact review and approval.

3) Sani�za�on of Government Files and Informa�on. As part of contract closeout and at expira�on of the contract, the Contractor (and/or any subcontractor) shall provide all required documenta�on to the CO and/or COR to cer�fy that, at the government’s direc�on, all electronic and paper records are appropriately disposed of and all devices and media are sani�zed in accordance with NIST SP 800-88, Guidelines for Media Sanitization.

4) No�fica�on. The Contractor (and/or any subcontractor) shall no�fy the CO and/or COR and system ISSO within 10 days before an employee stops working under this contract.

5) Contractor Responsibili�es upon Physical Comple�on of the Contract. The contractor (and/or any subcontractors) shall return all government informa�on and IT resources (i.e., government informa�on in non-government-owned systems, media, and backup systems) acquired during the term of this contract to the CO and/or COR. Addi�onally, the Contractor shall provide a cer�fica�on that all government informa�on has been properly sani�zed and purged from Contractor-owned systems, including backup systems and media used during contract performance, in accordance with HHS and/or IHS policies.

Payment Schedule: for Base Period

The Contractor shall submit an invoice based on the comple�on and acceptance of the below listed items.

TASK TASK NAME QUANTITY UNIT TOTAL TOTAL

1-4 Tasks 1-4.Develoment of curriculum, mee�ngs, and edits

5 Implementa�on of onsite training

6-7 Edit, quality assessment and evalua�on

Total

Payment Schedule: for Base Period