Virtual Medical Consultation Specialist RFP - July 2022 V2 Draft RFP.pdf

U.S. Department of State Virtual Medical Specialist Consultations

Bureau of Medical Services RFP #: 19AQMM22R0152

SENSITIVE BUT UNCLASSIFIED

U.S. Department of State

Office of Acquisitions Management supporting

Bureau of Medical Services

Virtual Medical Specialist Consultations

RFP #: 19AQMM22R0152

Contract

Attachment Title

A Quality Assurance and Surveillance Plan

RFP

Attachment Title

1 Pricing Tables

2 Virtual Consultation Operational Workflows

3 Template for Vendor Questions

4 Relevant Experience Questionnaire

5 Past Performance Questionnaire

6 Subcontracting Plan Template

Mission of the U.S. Department of State: The U.S. Department of State is the lead institution for the conduct of American diplomacy and the Secretary of state is the President’s principal foreign policy advisor. The Department of State’s mission is to advance U.S.

national security interests, fight terrorism, protect U.S. interests abroad, and implement foreign policy initiatives that build a freer, prosperous, and secure world.

Mission of the Bureau of Medical Services: MED executes the Department’s worldwide

Medical Program, serving over 70,000 U.S. Government employees and family members

(EFM) from more than 75 federal agencies engaged in the advancement of America’s interests and national security abroad. MED’s mission embraces the dual-objectives of the

President’s FY 2018 Budget Blueprint, supporting “national security and public safety to keep Americans safe while delivering flexible, patient-centered, and market-driven healthcare solutions that maximize private sector innovation, third-party reimbursement, host-nation infrastructure, and new technologies, to deliver the most cost-effective healthcare system in the U.S. Government.” Overseas, MED provides clinical, preventive, occupational and mental health care services, manages hospitalizations and medical evacuations, assesses local health threats, and allocates medical resources for all Chief of Mission personnel.

Domestically, MED advises the Secretary on the impact of global health issues such as

COVID-19, Ebola virus disease, Zika virus, and air pollution, forecasting their impact on

Department operations and risks to staff and private American citizens. The Medical Director also serves as the Department’s Designated Agency Safety and Health Official (DASHO), responsible for ensuring a safe and healthful work environment.

Scope: This is a non-personal services contract to provide real-time medical specialist consultations for emergency, urgent, and non-urgent medical care conducted via a modern, secure telehealth platform.

Type of Contract: Stand-alone

Set-Aside: Unrestricted

NAICS: 622110- General Medical and Surgical Hospitals

Place of Performance: All services rendered via this contract vehicle will only be provisioned to patients who are U.S. citizens and are physically located within the U.S. or on the campus of an American embassy/consulate abroad.

Period of Performance: This contract is comprised of one (1) 12-month base period and four (4), 12-month option periods and one (1) six-month option to extend granted by FAR

52.217-8.

Questions Related to RFP Due: NLT 12:00 pm (Eastern) on August 10, 2022

Proposal Due: NLT 12:00 pm (Eastern) on August 24, 2022

SECTION B – SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 OVERVIEW

The U.S. Department of State (“DOS”, “State”, or “the Department”), Bureau of Medical

Services (MED) has a need for real-time medical specialist consultations for emergency, urgent, and non-urgent medical care conducted via a modern, secure telehealth platform.

B.2 TYPE OF CONTRACT

a) This is stand-alone contract for commercial services.

b) The following table reflects the Contract Line Item Number (CLIN) that will be funded for this contract:

CLIN Description Contract Type

X001 Medical Specialist Consultations Firm-Fixed-Unit Price

X002 Program Management Firm-Fixed-Price

X003 Other Direct Costs (ODCs) Materials portion (M) of

Time-and-Materials

‘X’ in CLIN identifier = Contract Year (e.g., 0 = Base Period; 1 = Option Year 1, etc.)

c) CLIN X001, Medical Specialist Consultations is comprised of the following Sub-CLINs:

Sub-CLIN Description/Item Contract Type Unit

X001A Type 1- Provider-Specialist Firm-Fixed-Unit Price Each

X001B Type 4- MED Washington-

Specialist Firm-Fixed-Unit Price Each

X001C Type 5- UME-Specialist Firm-Fixed-Unit Price Each

d) The consultations for which the Department is responsible for payment is included in these

Sub-CLINs. The consultations and ancillary health services for which payment must be remitted by patients’ insurance are not included in these Sub-CLINs.

Those consultations and other services that must be paid for by patients’ insurance include

Type 2 (Provider – Patient – Specialist), Type 3 (Patient-Specialist), and Ancillary Health

Services. Please reference the paragraphs entitled “INVOICING AND PAYMENT” under the following sections:

• Type 2: See Section C.4.1.2

• Type 3: See Section C.4.1.3

• Ancillary Health Services: See Section C.4.2

e) Firm-fixed-price (see FAR 16.202) = Payment at negotiated firm-fixed-price. Negotiated firm-fixed-price includes direct labor costs, direct non-labor costs, applicable indirect costs, and profit.

f) Firm-fixed-unit-price (FFUP) = Payment at negotiated firm-fixed-unit-price. Negotiated

FFUP includes all direct costs, applicable indirect costs, and profit.

g) Materials portion of time-and-materials (see FAR 16.601) = Payment at allowable actual incurred materials/other direct costs and applicable indirect costs.

h) This is a non-personal services contract, as defined in FAR 37.101. Inherently governmental functions, as described in FAR 7.503 or by the ordering agency, are prohibited under this contract. The Government will neither supervise Contractor employees nor control the method by which the Contractor performs the required tasks. The Contractor shall manage its employees and guard against any actions that are of the nature of personal services or give the perception of personal services. The Contractor shall notify the Contracting Officer immediately if it perceives any actions that constitute personal services. This contract shall not be used to perform any inherently governmental functions.

B.3 PRICING TABLES

The following table displays the negotiated firm-fixed-unit-prices for Sub-CLINs X001A-

X001C. To be completed at time of award.

Sub-CLIN + Description

Base

Year

Option

Year 1

Option

Year 2

Option

Year 3

Option

Year 4

Six-

Month

Option

X001A: Type 1- Provider-Specialist

X001B: Type 4- MED Washington-

Specialist

X001C: Type 5- UME-Specialist

B.4 NOT-TO-EXCEED (NTE) PROFIT PERCENTAGES

a) This section applies when profit is an applicable element (e.g., under fixed-price, labor-hour, and time portion of time-and-materials arrangements) and when:

1. proposing and negotiating new cost elements (e.g., new firm-fixed-unit-prices and other direct costs) in the contract; and/or

2. changes (i.e., additions and/or deletions) in negotiated contract pricing occur.

b) Examples of this section’s applicability are when proposing and negotiating:

1. fully-loaded hourly labor rates for labor categories not already identified in the contract;

2. fixed-price CLINs;

3. equitable adjustments under fixed-price CLINs.

c) The following are the negotiated NTE profit percentage(s):

Base Period: NTE ___% To be completed at time of award

Option Year 1: NTE ___%

Option Year 2: NTE ___%

Option Year 3: NTE ___%

Option Year 4: NTE ___%

Six-Month Option to Extend (see FAR 52.217-8): NTE ___%

B.5 PERIOD OF PERFORMANCE

This contract is comprised of a one-year base period, four, one-year option periods (plus a six-month option to extend in accordance with FAR 52.217-8).

Base Year: To be completed at time of award

Option Year 1:

Option Year 2:

Option Year 3:

Option Year 4:

Six-Month Option to Extend (see FAR 52.217-8):

SECTION C – PERFORMANCE WORK STATEMENT

C.1 OVERVIEW AND BACKGROUND

The mission of the Bureau of Medical Services (MED) is to safeguard and promote the health and well-being of America’s diplomatic community. MED administers the Department of

State’s (Department or DOS) health care program mandated by the Foreign Service Act of

1980, develops, and implements medical policies for the Department, and advises the

Secretary on global health care issues. MED supports the most globally distributed primary and occupational health care system for civilian employees and eligible dependents in the federal government. In over 220 locations around the world, MED supports a direct hire workforce of over 75,000 employees, and an embassy community with well over 150,000 persons. MED’s global healthcare network is spread across over 200 Health Units (HU) and posts. As medical science advances and blends with emerging technology, MED must keep pace to provide a world-class standard of medical care on a global scale. MED’s patient population covers all stages of life, including pediatrics, obstetrics, adults, and geriatrics.

MED encounters almost every disease Americans have. MED’s health care staff support patients worldwide, and as such, must be sensitive to language barriers and cultural differences.

MED’s health care providers have a varied range of experience and training and many practice in medically austere diplomatic missions. The American health care model (and standards of care) assumes clinicians have ready access to medical specialists to collaborate in the management of chronic or evolving medical conditions. Currently many of MED’s medical clinicians operate without access to these specialist resources that are a critical component of a complete healthcare capability.

MED’s current telemedicine program focuses on rapid access to emergency care and specialist consultations in relation to emergency care visits. At present, MED providers can call in and speak with an Emergency Room (ER) physician (provider to provider) at a level one trauma center in the U.S., 24 hours per day, seven days per week (24/7). If the consultation is emergent or deemed an “emergency”, the ER physician will provide real-time guidance to the provider on the ground. If it is a non-urgent specialty consultation, the request is routed to the appropriate specialist and a written report is returned in 24 hours. Currently, there is a limited list of available specialties. Since the implementation of that program, there have been approximately 800 consults completed.

MED seeks to expand its access to specialist consultations to improve our ability to meet the needs of our employees and their eligible family members. Specifically, MED seeks to contract with a hospital system or other similar network of U.S. board certified medical specialists who can provide dynamic, comprehensive, and efficient specialist support to augment our global MED healthcare staff. Additionally, MED seeks to build relationships with specialists, as well as ensure that our patients receive continuity in their medical care.

C.2 OBJECTIVES

MED seeks to contract with a healthcare provider to access their network of U.S. board certified specialists. Based on MED’s global footprint it is anticipated that these consultations and ancillary services will be conducted via the provider’s telehealth platform.

Access to specialists shall include 24/7 support for emergency care, as well as rapid support for urgent and non-urgent medical care, chronic care across specialties, and mental health services to ensure patients and practitioners in all time zones are able to access specialist care during standard business hours.

MED’s objectives for this effort include:

• Enhanced quality of care for Department of State personnel overseas

• Reduced costs associated with specialist consultation related travel

• Improved customer experience for employees and eligible family members

C.3 SCOPE

The Contractor shall provide real-time medical specialist consultations for emergency, urgent, and non-urgent medical care including chronic condition management, as well as mental health services. These consultations in most all cases shall be conducted via the provider’s telehealth platform based on the global footprint of MED’s patient population.

For the purposes of this contract, emergency means the ailment is considered life threatening at present; urgent means the ailment could be life threatening; and non-urgent means routine.

The Contractor shall provide MED with the ability to access all U.S. board certified specialties to support its patient population, including but not limited to neonates, pediatrics, adults, and geriatrics, as well as physical and mental health. Personnel identified as a specialist shall have appropriate professional licensure associated with that specialty. For historical purposes, from 2017-2021, the majority of MED’s teleconsultations were based on urgent or emergent inquiries related to orthopedics, surgery, and radiology inquiries. Other less frequent teleconsultations included:

• Peds Orthopedics

• Emergency Medicine (24/7)

• Neurology

• Dermatology

• Neurosurgery

• Gastroenterology

• Obstetrics and Gynecology

• Ophthalmology

• Neonatal Intensivist

• Urology

• Endocrinology

• Pulmonary

• Podiatry

• Hematology/Oncology

• Oral Surgery

• ENT

• Pain Management

• Rheumatology

• Peds Endocrine

• Peds Oncology

The above list of specialties is not all-encompassing. The Contractor is required to provide access to all specialties as required by the Government. All specialists provided by the

Contractor in support of this contract must be U.S. board certified and have valid state licensure, which enables them to provide support efforts in a federal facility. MED anticipates that all patients supported by this contract will be located Outside the Continental

United States (OCONUS), but virtual consultations may be provided OCONUS or

Continental United States (CONUS).

All services rendered via this contract vehicle will only be provisioned to patients who are

U.S. citizens and are physically located within the U.S. or on the campus of an American embassy/consulate abroad.

The Contractor shall conduct medical consultations through its existing telehealth solution.

MED requires all services identified in this Performance Work Statement (PWS) to be available within 30 calendar days of contract award.

C.4 REQUIREMENTS

This section describes the requirements associated with the provision of medical consultations provided by specialists to support MED. All information collected while conducting the required services delineated by this PWS shall be considered Protected Health

Information (PHI) and Personally Identifiable Information (PII) and shall not be disclosed without the expressed written permission of the Contracting Officer’s Representative.

C.4.1 Medical Specialist Consultations

The Department seeks to increase access to medical specialists through contracting for real-time virtual consultations. The Department seeks to bridge a gap in service offering for its overseas patients by connecting them with specialist consultations that may not be available where they are stationed. The Contractor shall provide consultations for all U.S. board certified specialties, including but not limited to the specialties identified in Section C.3.

There are five types of virtual consultations which MED anticipates requiring, including:

• Type 1: Overseas Health Unit Provider to Specialist Consult (Provider – Specialist)

• Type 2: Overseas Health Unit Provider and Specialist to Patient Visits (Provider –

Patient – Specialist)

• Type 3: Overseas Patient to Specialist Visits (Patient – Specialist)

• Type 4: MED Washington to Specialist Consults (MED Washington – Specialist)

• Type 5: Unintended Medical Events (UME) to Specialist Consults (UME –

Specialist)

Please see RFP Attachment 2 – Virtual Consultation Operational Workflows to view the current process for each consultation type. These workflows may be revised during the life of the contract.

The U.S. diplomatic community operates across all time zones. For each consultation type deemed non-urgent, consultations must be scheduled and conducted according to the patients’ time zone. Specialists shall be sensitive to patient time zones and shall accommodate patients’ needs, to the maximum extent practicable. Patients will not be required to meet U.S. standard time zones.

During the first two years of contract performance, MED anticipates fewer consultations will be required. MED estimates approximately 250-300 consultation requests will be received per years one and two, for all consultation types, based on available urgent and emergent

Health Unit data and historical information. Once this effort is more established and integrated into the global MED services offering, it is anticipated the volume of consultations could rise into the 2,000-2,500 range on an annual basis across all five consultation types.

Volumes per specialty cannot be provided at this time as this is a new service offering.

However, for estimation purposes, MED’s patient populations’ top utilized specialties typically coincide with the U.S. basic population that medical providers currently support

(e.g., orthopedics, cardiac, cancer, gastrointestinal, OB/GYN, dermatology, pediatrics orthopedics, endocrine, etc.). Historically, non-urgent consultations are typically 45 minutes in length on average.

Payment for virtual consultations is described within each consultation type. For each consultation type in which the patient is responsible for billing, it should be noted that State

Department beneficiaries are required to maintain U.S. health insurance. The two primary insurance carriers are Foreign Service Benefit Plan and Blue Cross Blue Shield Federal. The

Contractor is responsible for ensuring particular plans cover telehealth. The Contractor must be able to identify at time of scheduling who is responsible for payment.

Consultations may only be provided to U.S. citizens, with the exception being extremely rare circumstance where there is a traumatic event on consulate or embassy grounds and provision of services to non-U.S. citizens is authorized by the Government.

C.4.1.1 Type 1: Provider – Specialist

A virtual encounter between an overseas Health Unit (HU) provider and a U.S.-based specialist for which the provider is seeking an opportunity to get the thoughts/expertise regarding a specific medical issue. The goal of these consultations is to:

➢ Engage in collaborative relationships with U.S. specialist providers.

➢ Facilitate learning for our overseas HU providers in relation to a clear clinical question in management of a patient’s care.

➢ Obtain evidence-based recommendations to determine the best course of action based on the clinical question from a provider to the specialist.

➢ Allow HU provider to continuing managing the patient’s care based on recommendations from the specialist.

➢ Improve access to specialty input to providers who often work in medically austere environments.

The Contractor shall triage consultations based on the patient’s severity and acuity. For example, the Contractor may assign a patient to Level 1 to consult with an ER physician, in which the consultation shall take place within 24 hours.

Any consultation request deemed “emergency” must be handled at the time contact is made with the specialist. MED requires a specialist, typically an ER physician, to be available 24/7 for emergency requests. Any consultation deemed “urgent” must be resolved within 24 hours.

INVOICING AND PAYMENT: The Department will be responsible for payment for Type

1: Provider – Specialist under the resulting contract.

C.4.1.2 Type 2: Provider – Patient – Specialist

Provide real-time live video consultations between a U.S. based specialist, the patient, and the HU personnel in the overseas Health Unit.

A virtual encounter occurs between an overseas patient, an overseas provider, and a U.S.

based specialist for lower-acuity (i.e., non-urgent) services. The goal of these visits is to:

➢ Improve access to U.S. based specialists for overseas patients.

➢ Increase convenience for patients by eliminating the need to travel. There may not be a specialist in country who meets U.S. standard of care which would require a patient to travel to a country with a higher level of care, or back to the U.S. for a visit with a specialist. For many low acuity concerns the time and effort is deemed unacceptable by the patient.

➢ Serves to bring the overseas provider/patient/specialist together to outline a plan of care that can be implemented by the HU provider.

INVOICING AND PAYMENT: The Department will not be responsible for billing for Type

2: Provider – Patient – Specialist. The specialist is responsible for billing the patient’s insurance. The patient is responsible for payment balance if the insurance does not pay in full.

C.4.1.3 Type 3: Patient – Specialist

Patients (i.e., U.S. diplomats) who are overseas with a chronic medical condition (amiable to telemedicine) that requires routine follow-up are able to schedule a virtual encounter directly with the U.S.-based specialist. Patients must obtain a referral from MED as the referring provider to schedule consultations under Type 3.

The goals of this service include:

➢ Improving patient compliance with recommended follow-ups to a specialist.

➢ Allowing patients to access a U.S. specialist without having to travel back to CONUS.

Consultations under Type 3: Patient-Specialist are considered non-urgent. These consultations shall be scheduled and completed within ten business days. An example of a

Type 3 consult may be a rheumatoid arthritis patient on a biologic therapy that can cause immuno-suppression. Even if subject is stable on the medication these therapies require regular check-in and monitoring by a specialist.

INVOICING AND PAYMENT: The Department will not be responsible for billing for Type

3: Patient – Specialist. The specialist is responsible for billing the patient’s insurance. The patient is responsible for payment balance if the insurance does not pay in full.

C.4.1.4 Type 4: MED Washington – Specialist

MED Washington serves as the “headquarters” for MED’s global healthcare program. MED

Washington is responsible for reviewing medical records for all deployable Department of

State employees to ensure medical fitness for duty. It is anticipated that the predominate usage of this consultation type will be for MED’s Office of Medical Clearances, who is responsible for ensuring the U.S. government personnel receive adequate medical evaluation and clearance prior to their assignments abroad. The purpose of a medical clearance is to identify specific health needs and medical conditions that may require specialty management, follow up, or monitoring. During the process of a medical clearance, U.S. licensed providers review the medical records of the patient. These reviews often introduce specific questions in relation to what type of care and monitoring an individual patient will require. For these issues it is necessary to seek consultation and collaboration with a specialist. The primary goal of this consultation type is to garner specialist subject matter expertise and objective data to enable Medical Clearances providers to assess patient risk level and feasibility for sending the patient to a specific country.

After completion of each Medical Clearance consultation under Type 4, the specialist shall submit a determination narrative based on his/her review of the patient’s medical records and other relevant information, detailing the level of risk (e.g., high, medium, low) and provide supporting evidence for that judgment. Medical Clearance consultations under Type 4: MED

Washington – Specialist are considered non-urgent. These consultations shall be scheduled and completed within ten business days.

4: MED Washington – Specialist under the resulting contract.

C.4.1.5 Type 5: UME – Specialist

MED’s Quality Management (QM) section is, in part, responsible for risk management control of the clinical care administered by MED worldwide. Clinical staff often operate without the readily available medical consultant and emergency resources that are common within the United States. Sometimes while administering care, unintended medical events

(UME) – any medical action that might cause harm to a patient, whether any actual harm transpired – occur (e.g., medication error, missed or delayed diagnosis, immunization error).

MED aims to detect and act on UMEs promptly to prevent poor outcomes and improve quality of care.

QM is charged with assessing reported UMEs for all MED healthcare providers. In instances where the QM Committee determines a MED provider requires clinical remediation after a

UME is reported, the committee may provide a Corrective Action Plan which refers the provider to an external specialist for additional education and training. The specialist shall provide the following services upon request:

• review the UME, the MED provider’s actions, and the Committee’s corrective action plan;

• provide clinical guidance and instruction on the appropriate standard of care and best practices in their area of expertise; and

• prepare a written summary of the UME review, clinical guidance provided, and recommendations for improvement

QM consultations under Type 5: UME – Specialist are considered non-urgent. These consultations shall be scheduled and completed within ten business days.

5: UME – Specialist under the resulting contract.

C.4.2 Ancillary Health Services

Similar to the medical consultations, the Contractor shall enable virtual encounters via the

Contractor’s telehealth platform and provide patients with ancillary health services, to include:

• Diabetes education o Provide patients with self-management skills, such as insulin administration and glucose monitoring

• Diet and nutrition education

• Lactation support

• Physical and occupational therapy

• Mental health support services, outside of psychotherapy

• Adolescent assessments (e.g., learning disabilities)

• Substance abuse support

Ancillary health services are considered non-urgent. These services shall be scheduled and completed within ten business days and in accordance with the patients’ time zone.

Specialists shall be sensitive to patient time zones and shall accommodate patients’ needs, to the maximum extent practicable. Patients will not be required to meet U.S. standard time zones.

INVOICING AND PAYMENT: All ancillary health services shall be charged to the patient’s insurance. The Department will not be responsible for billing for ancillary health services.

C.4.3 Telehealth Platform

Critical to the provision of virtual consultations is a modern, secure telehealth platform. MED requires the Contractor to conduct virtual consultations through its existing telehealth solution.

C.4.3.1 Contractor-Provided Telehealth Platform

The Contractor shall conduct virtual consultations through its existing modern, secure telehealth solution. The Contractor is responsible for hosting, owning, managing, and maintaining the platform. As consultations will occur throughout the world, patient and HU bandwidth capabilities are variable. Therefore, the telehealth platform must be configurable to accommodate varying bandwidth and latency rates. It is incumbent upon the Contractor to conduct consultations that align with patient needs based on the technology available to them.

The Contractor shall provide access to MED and its patients via login administration and management by assigning user IDs and passwords. The Contractor shall also provide Tier 1 helpdesk support to users to assist with items such as scheduling appointments, resetting passwords, etc. Additionally, the Contractor shall provide patients with user guides and/or written/verbal instructions to use the platform. The telehealth platform shall include a public facing web application user interface for users to participate in virtual consultations.

The Contractor’s telehealth platform shall include the following capabilities:

• Conduct the virtual consultations and ancillary health services outlined in PWS

Section C.4.1 and C.4.2, respectively, through audio, video, and chat functionalities

• Patient scheduling

• Appointment reminders

• Waiting room management

• File upload by patients, DOS providers, and third-party providers

• Near real-time dashboard and/or reportability functionality for comprehensive reporting, analytics, and quality metrics

Additionally, the Government seeks a telehealth platform that has an option to discern the party responsible for payment for each consultation type and ancillary health service, as well as the capability to identify the patient’s insurance.

The Contractor’s telehealth platform shall be available 24/7/365 to support MED’s global health care patient populous. The platform shall meet all industry standard HIPAA requirements and comply with the Privacy Act of 1974. The Contractor is responsible for maintaining the security of its platform, to include preventing and/or responding to any breaches. Moreover, the Contractor shall obtain patient consent prior to conducting virtual consultations, stating that medical records may be provided to the patient’s employer.

The Contractor’s telehealth platform shall allow access to records by MED staff on an as needed basis. Any records created shall be able to be exported in standard HL7 format, or other industry standard format, for incorporation into current and any future MED health records systems and/or platforms.

The Contractor’s telehealth platform must allow third party health providers to log in and upload medical imagery. Due to HIPAA regulations, medical imagery cannot be emailed.

For pathology, the slides or tissue block would be sent to the Contractor's pathology unit for interpretation. Laboratory functions must be certified to U.S. standards.

C.4.3.2 Hardware

Initially, the Government will supply Health Unit providers with iPads to participate in relevant virtual consultations. It is anticipated that the Government will also supply Health

Unit providers with tablets, computers, and phones for virtual consultations during the life of the contract.

The Contractor is required to provision hardware for its specialists and other personnel to conduct consultations and/or otherwise provide services for this contract.

C.4.4 Program Management

The Contractor shall provide comprehensive oversight and management of the medical services provided under this contract to ensure the highest quality of care is provided to MED and its patient population. The Contractor shall designate a single point of contact to serve as the “Program Manager” who will be responsible for all contract deliverables and function as the main point of contact for program related communications.

For all consultation requests and ancillary health services, the Contractor shall field, route, and assign to the appropriate specialist. For non-urgent requests, the Contractor shall establish a mechanism (e.g., patient scheduling portal or online patient portal) where any patient can submit a request for consultation or ancillary health service. Additionally, the

Contractor shall be able to receive emergency requests by telephone. For any request deemed

“emergency,” the Contractor must have someone available to physically answer the phone

24/7 to quickly disseminate the request to the appropriate specialist. The Contractor is required to continually check the established mechanism to view requests from its Program

Manager and/or patients. Consultations shall be completed within the timeframe allotted as specified in PWS Sections C.4.1. and C.4.2.

The Contractor shall ensure its work efforts and deliverables are well-considered, logical, consistent, and fulfill the performance requirements. The Contractor shall apply a consistent, coordinated, and process-driven approach to provide high-quality services and deliverables on-schedule and within the price set forth by the contract. The Contractor shall effectively manage and administer all efforts performed under this contract through rigorous planning, execution, monitoring, and improvement processes.

The Contractor shall provide qualified and effective resource management to ensure technically proficient personnel provide excellent support throughout the life of the contract.

The Contractor shall appropriately allocate personnel to tasks, activities, and projects using a sensible and logical approach to ensure all requirements are met. Additionally, the

Contractor is responsible for continuously overseeing and maintaining the credentials for all medical specialists that will provide services under this contract, to ensure they are appropriately qualified to provision the medical care that is requested of them. Credentialing shall occur at least every three (3) years. Credentials are documented evidence of licensure, education, training, experience, or other qualifications.

C.4.4.1 Reports

Throughout the contract period of performance, the Contractor shall provide status updates via the following methods.

C.4.4.1.1 Consultation Reports

The Contractor shall submit a comprehensive written report after each completed consultation and/or ancillary health service rendered. These reports will follow a Subjective, Objective, Assessment, and Plan (SOAP) note format. Each report shall include:

• Patient name

• Patient date of birth

• Patient agency

• Patient location/post assignment

• Medical provider requesting consultation

• Date of consultation/ancillary health service

• Consultation/ancillary health service type

• Medical specialty

• Specialist diagnosis

• Identify whether or not medical evacuation (medevac) occurred or if medevac was prevented due to consultation

These reports shall be marked with “PHI” and/or “PII” to signify the report contains

Protected Health Information (PHI) or Personally Identifiable Information (PII). Reports will be completed and transmitted to the medical specialist identified at the time of service, as well as the COR, within 72 hours of completion of consult. Reports and any accompanying notes or records shall be encrypted with password protection to be subsequently transmitted to MED for upload into the patient’s electronic file.

C.4.4.1.2 Monthly Status Report (MSR)

The Monthly Status Report (MSR) shall provide the Government with a comprehensive view of the services provided under the contract. The MSR shall include at a minimum, a list of all virtual consultations provided during the month prior to MSR submission to include the consultation type, specialty type, and consultation date. The MSR will also address contract funding status, including remaining funds and expended funds. The Government will provide the Contractor with a MSR template.

C.4.4.2 Customer Service and Support

The Contractor is expected to maintain a customer-focused approach when conducting virtual consultations. This entails providing quality support in a timely manner. The

Contractor shall develop a Customer Satisfaction Survey to use in soliciting patient feedback and gauging satisfaction for areas of service performed under this contract.

C.5 PERFORMANCE MONITORING

The Government will provide a Quality Assurance Surveillance Plan (QASP) to monitor the

Contractor’s performance. The QASP will provide oversight help to ensure that service levels reach and maintain the required levels for performance of this task. Further, the QASP provides the COR with a proactive way to avoid unacceptable or deficient performance and provides verifiable input for required Past Performance Information Assessments. The QASP is a living document and may be updated by the Government as necessary. Any updates to the QASP will be provided to the Contractor.

The following table identifies technical performance standards that align with PWS tasks.

The Contractor shall establish a performance baseline or minimum Acceptable Quality Level

(AQL) and define a target performance level for each metric. Should the minimum AQL not met during performance, the Contractor shall implement a process for corrective action and quality improvement.

Required Service and

RFP Reference

Standard (Objective) Performance

Threshold/AQL

Medical Specialist

Consultations (C.4.1) and Ancillary Health

Services (C.4.2)

Any consultation request deemed “emergency” is handled at the time contact is made with the specialist. A specialist is available 24/7 to handle emergency requests.

No deviation

Any consultation request deemed “urgent” is resolved within 24 hours.

No deviation

Any consultation request or ancillary health service request deemed “non-urgent” is scheduled and completed within ten business days.

No deviation

Telehealth Platform

(C.4.3)

The Contractor’s telehealth platform and all functionalities are available and accessible.

Average platform uptime 99.5%

The near real-time data provided via dashboard and/or reportability functionality is 100% accurate and reflects all services required by this PWS.

No deviation

Program Management

(C.4.4)

All consultation reports are completed and transmitted within 72 hours of completion of consult.

No more than three consultation reports are submitted after 72 hours per year

A high quality of care is provided to patients, measured by customer satisfaction surveys.

Average rating of at least 4 out of 5 (or adjectival/ percentage equivalent) will be considered meeting performance standard

C.6 IN-SCOPE SERVICES

As prescribed by this document, the Government considers services covered under the following NAICS codes to be within the scope of this contract:

NAICS Description

622110 General Medical and Surgical Hospitals

621111 Offices of Physicians (except Mental Health

Specialists)

621112 Offices of Physicians, Mental Health Specialists

622210 Psychiatric and Substance Abuse Hospitals

622310 Specialty (except Psychiatric and Substance

Abuse) Hospitals

621399 Offices of All Other Miscellaneous Health

Practitioners

Required Service and

RFP Reference

Standard (Objective) Performance

Threshold/AQL

Deliverables are delivered by specified deadlines and are thorough, complete, comprehensive, free from error, and comply with all templates and other guidance.

No more than five deliverables are returned by the COR to the Contractor for additional work and resubmission per year

SECTION D – PACKAGING AND MARKING

D.1 MARKING OF REPORTS

All reports delivered by the Contractor to the Government under this contract shall prominently show on the cover of the report:

a) Name and address of the Contractor

b) Contract number

c) Date of report

d) Program office(s) (e.g., Directorate of Clinical Programs)

The Contractor shall not include any company watermarking or statement that would prevent the Government from utilizing or circulating the information contained in the report. If there are issues with the potential proprietary nature of the information, it shall be brought to the attention of the Contracting Officer’s Representative for resolution.

Unless otherwise requested, reports shall be submitted electronically as identified in

Section F.3.

SECTION E – INSPECTION AND ACCEPTANCE

E.1 CLAUSES INCORPORATED BY REFERENCE – FAR 52.252-2 (FEB 1998)

This contract incorporates one or more clauses by reference with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

FAR: www.acquisition.gov/far

DOSAR: www.statebuy.state.gov/DOSar

These website addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, the Contractor may use an Internet search engine such as Google or Yahoo to obtain the latest location of the most current FAR.

Clause Title Date

52.246-2 Inspection of Supplies – Fixed Price Aug 1996

52.246-3 Inspection of Supplies – Cost-Reimbursement May 2001

52.246-4 Inspection of Services – Fixed Price Aug 1996

52.246-5 Inspection of Services – Cost-Reimbursement Apr 1984

52.246-16 Responsibility for Supplies Apr 1984

E.2 INSPECTION AND ACCEPTANCE

a) The CO’s representatives are provisionally responsible for inspection and acceptance of the Contractor’s effort under this contract. It is agreed upon by both parties that written acceptance or rejection of services under this contract shall be furnished by the

Government, either physically or through electronic communications, within ten (10) business days following delivery. The CO is ultimately responsible for inspection and acceptance. The Contractor shall submit quarterly Quality Assurance and Compliance

Reports (QACR) showing how it met or failed to meet the performance requirements listed in the contract. If the Contractor failed to meet the acceptable quality level (AQL) for a given performance requirement, it shall submit a detailed narrative as to what actions have been taken to mitigate any future non-compliance.

b) If the Contractor believes that mitigating circumstances precluded the Contractor from meeting the terms and conditions of the contract as it relates to performance or administration of the contract, a request for waiver can be requested. The Contractor shall provide a detailed explanation as to why the circumstances surrounding the contract noncompliance occurred and why this action could not have been prevented. This request must be submitted to the Government within seven (7) calendar days from receipt of notice of noncompliant performance, unless otherwise approved by the CO.

http://www.acquisition.gov/far http://www.statebuy.state.gov/dosar

c) The Contractor shall only tender for acceptance those services or analytical results that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The

Government may require repetition of nonconforming services at no increase in contract price. The Government must exercise its post-acceptance rights within a reasonable time after the defect was discovered or should have been discovered.

d) The Contractor is responsible for performing or having performed all inspections and tests necessary to substantiate that the services furnished under this contract conform to contract requirements, including any applicable technical requirements for specified manufacturers’ parts. This clause takes precedence over any Government inspection and testing required in the contract’s specifications, except for specialized inspections or tests specified to be performed solely by the Government.

e) Throughout contract performance, the Contractor shall be proactive in identifying new simple, measurable, and meaningful performance metrics to be used in performing the requirements of this contract.

E.3 GOVERNMENT QUALITY ASSURANCE

a) The Contractor, not the Government, is responsible for management and quality control to meet the terms of the contract. The role of the Government is to conduct quality assurance to ensure that standards are achieved.

b) The Government will perform those quality assurance procedures that may be necessary to verify that performance is in accordance with the terms of the contract. Government quality assurance will be performed routinely by the Contracting Officer’s representatives (e.g., COR, ACOR, GTM). However, other representatives, including third party contractors, may be called upon to support this effort as required. The COR or designated quality assurance evaluators will record all surveillance observations and will maintain a file of all inspection results. Instances of unsatisfactory performance may result in appropriate actions taken by the Contracting Officer in accordance with the terms of this contract.

c) In the event that an inspection identifies performance deficiencies, the COR may require the Contractor to explain, in writing, why performance was unacceptable, how performance will be returned to acceptable levels, and how recurrence of the problem(s) will be prevented in the future. The COR will evaluate the Contractor's explanation and take appropriate action.

d) The Contractor shall promptly correct and improve any shortcomings noted during inspections. The Contractor shall also bring any conditions beyond the responsibility of the Contractor to the attention of the CO.

E) The terms in this section are designed to complement the provisions in the FAR

Inspection clause.

SECTION F – DELIVERIES OR PERFORMANCE

F.1 CLAUSES INCORPORATED BY REFERENCE – FAR 52.252-2 (FEB 1998)

This contract incorporates one or more clauses by reference with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

FAR: www.acquisition.gov/far

DOSAR: www.statebuy.state.gov/DOSar is not available at the locations indicated above, the Contractor may use an Internet search

52.211-08 Time of Delivery June 1997

52.211-17 Delivery of Excess Quantities Sept 1989

52.242-15 Stop-Work Order Aug 1989

52.242-15 Stop-Work Order Alt. I Apr 1984

52.242-17 Government Delay of Work Apr 1984

52.247-34 F.O.B. Destination Nov 1991

52.247-35 F.O.B. Destination, within Consignee’s Premises Apr 1984

52.247-48 F.O.B. Destination – Evidence of Shipment Feb 1999

F.2 PERIOD OF PERFORMANCE

This contract is comprised of one (1) 12-month base period and four (4), 12-month option periods and a six-month option to extend granted by FAR 52.217-8.

F.3 DELIVERABLES

The Contractor shall provide the following deliverables in the timeframe and format prescribed. The CO shall notify the Contractor in writing of any additional deliverables that may arise during contract performance. The table below defines all the relevant Contractor deliverables. With regard to the Contractor-produced reports required in the table below, the

Government will have ten (10) business days to review the deliverable documents, either accepting them as is or returning them to the Contractor with feedback and requesting action.

If the Government returns the document requesting correction, the 10-day review cycle applies to each subsequent document version review. If the Government does not respond http://www.statebuy.state.gov/dosar within ten (10) business days, the Contractor may consider the document deliverable as accepted.

Reference Deliverable Frequency Distribution

- Kick-Off Meeting Once

Within 21 calendar days of contract award

Attendance: CO, COR, Contractor representatives, and other MED stakeholders

C.4.4.1.1 Consultation Reports As needed Within 72 hours of completion of consult

MED Physician/medical provider, COR, ACOR

C.4.4.1.2 Monthly Status

Reports Monthly

The 25th day of each month

CO, COR, ACOR

C.4.4.2 Customer Satisfaction

Survey Once

Within 30 calendar days of contract award

COR, ACOR

E.2(a)

Quality Assurance and Compliance

Reports

Quarterly

The 25th day of every third month

CO, COR, ACOR

SECTION G – CONTRACT ADMINISTRATION DATA

G.1 CONTRACT ADMINISTRATION

This contract will be administered as follows:

Contracting Officer (CO)

Kelley Kershner

KershnerK@state.gov

Contracting Officer’s Representative (COR)

TBD

Alternate Contracting Officer’s Representative (ACOR)

TBD

Written communications regarding the administration of this contract shall make reference to the contract number and shall be submitted electronically to the CO, COR, and ACOR at the email addressed above.

G.1.1 CONTRACTING OFFICER

The Contracting Officer (CO) has sole authority to modify the terms of this contract. The

Contractor is responsible for ensuring that all deviations from contract requirements are approved by the CO.

G.1.2 CONTRACTING OFFICER’S REPRESENTATIVE

The Contracting Officer will designate in writing one or more Government employees, by name and position title, to take action for the Contracting Officer under this contract. Each designee shall be identified as a Contracting Officer’s Representative (COR) or Alternate

Contracting Officer’s Representative (ACOR). Such designation(s) shall specify the scope and limitations of the authority so delegated.

G.1.3 GOVERNMENT TECHNICAL MONITOR (GTM)

A Government Technical Monitor (GTM) may be designated to provide technical monitoring, advice and assistance, in the monitoring and evaluation of the Contractor’s performance.

G.2 TECHNICAL DIRECTION

a) Contract performance shall be subject to technical instructions, whether oral or written, issued by the COR specified in Section G.1. Technical instructions must be within the general scope of work stated in the contract. Technical instructions may not be used to:

1) Assign additional work or reduce work under the contract.

2) Direct a change as defined in the "Changes" clause of this contract.

3) Increase or decrease the contract price or estimated contract amount (including fee), as applicable, the level of effort, or the time required for contract performance.

4) Change any of the terms, conditions, or specifications of the contract.

b) If, in the opinion of the Contractor, any technical instruction calls for effort outside the scope of the contract or is inconsistent with this requirement, the Contractor shall notify the Contracting Officer in writing within two (2) business days after the receipt of any such instruction. The Contractor shall not proceed with the work affected by the technical instruction unless and until the Contractor is notified by the Contracting Officer that the technical instruction is within the scope of this contract or a change order is issued.

c) Nothing in this section shall be construed to excuse the Contractor from performing that portion of the contractual work statement that is not affected by the disputed technical instruction.

G.3 INVOICE AND REPORTING REQUIREMENTS

The Contractor is required to provide an electronic copy of each invoice. The invoice shall contain all information required in Section G and Section I.

The Contractor shall submit all invoices within 15 business days of complete delivery of services.

G.3.1 INV-IPP ELECTRONIC INVOICING AND PAYMENT REQUIREMENTS

AND INSTRUCTIONS TO IMPLEMENT USAGE OF THE INVOICE

PROCESSING PLATFORM (IPP)

(a) Definitions. As used in these instructions

(1)”Payment request” means a bill, voucher, invoice, or…