Performance Work Statement_Revised_20210721.pdf

Performance Work Statement (PWS) Medical Records

Performance Work Statement (PWS)

State Service Treatment Record (STR) Maintenance Office

Mission Statement

State STR Maintenance Office (SSMO) supports the medical readiness of the Nebraska Army National Guard in order to ensure the NEARNG meets Department of the Army’s medically deployable standards. State STR Maintenance Office facilitates continuity of care by sharing records with the VA, civilian medical organizations and other DOD facilities.

1.0 General

The use of SSMO be utilized to support the Medical Readiness of Soldiers assigned the Nebraska Army National Guard (NE ARNG). This support will be utilized to the NEARNG medical readiness IAW DOA mission goals. SSMO will be utilized in aspect and processes to support Medical Readiness programs and processes.

Period of Performance Base Period: 1 September 2021 - 31 August 2022 Option Year 1: 1 September 2022 - 31 August 2023 Option Year 2: 1 September 2023 - 31 August 2024 Option Year 3: 1 September 2024 - 31 August 2025 Option Year 4: 1 September 2025 – 31 August 2026

Place and Performance of Services: Primary Work location will be 2400 NW 24th Street, Lincoln NE 68524

1.1 Medical Administrative Functions - The Contractor shall provide qualified Health Information Technology candidates with skills required to fulfill administrative functions supporting the SSMO in providing Medical Record (MR) support. Duties include, but are not limited to scanning and filing; retiring medical records; and releasing PHI;

validating EHR. Records will be maintained both electronically and hard-copy.

2.0 Performance Requirements

2.1 Scan and/or file the medical/dental documents; electronic and hard copy. The Contractor will organize/index batches.

Performance Standards

a) Standard: Filing in the Electronic Health Record includes uploading the appropriate health record, in the correction location, in the correct order, and indexing any documents IAW AR 40-66, current policy guidance and current local SOP.

AQL: No More than two documents scanned/indexed in error for the month. New documents will be scanned/indexed within 7 days of receipt.

2.2 The contractor will retire medical records with priority given to soldier’s separating in the next 30 days.

2.2.1 The contractor will ensure each document matches the patient’s identification, remove, and refile and document not matching the patient.

2.2.2 Ship retired medical records to the Army Records Personnel Center in San Antonio, TX. Address can change upon storage requirements.

Performance Standards

a) Standard: Soldiers’ records, separating in the next 30 days according to the Separating Soldiers Report, are verified within 25 days of loss date IAW AR 40-66.

AQL: Any record not verified within 25 days of loss date.

2.3 The Contractor will release Protected Health Information (PHI) IAW AR 40-66, current policy guidance and current local SOP.

Performance Standards

a) Standards: PHI will be release within 30 days of receipt of authorized form for disclosure IAW AR 40-66.

AQL: PHI was not released within the 30 days.

2.4 Contractor will validate the Electronic Health Record in the Health Readiness Record module IAW AR 40-66 and PPOM 16-017.

Performance Standards

a) Standards: The Electronic Health Record has been validated between 15 days prior to the loss of the Soldier to 25 days after the separation date of the Soldier IAW AR 40- 66 and PPOM 16-017.

AQL: The Electronic Health Record was not validated by the 25th day after the separation of the Soldier.

3.0 Deliverables

PWS Paragraph Reference Deliverable Initial Delivery Subsequent Delivery Method of Contact

Number Name Frequency Quantity

A01 Information Assurance Training Completion Certificate Information Assurance Training Completion Certificate https://informationassurance.us.army.mil

A02 NACI Investigation Once Complete NACI investigations on all employees prior to start date

A03 Thirty minute meeting once a week with Patient Administration Division personnel

A04 Separating Soldiers Report update report on the 1st and 15th of each month

4.0. General Requirements

Common Access Card (CAC) Requirements: The CAC is the Department of Defense (DOD) Federal Personal Identity Verification (PIV) credential. In accordance with Directive Type Memorandum (DTM) 08-003, December 1, 2008, incorporating Change 5, October 8, 2013, Initial issuance of a CAC requires at a minimum, the completion of FBI fingerprint check with favorable results reflecting "No Record" and submission of a National Agency Check with Inquiries (NACI) to the Office of Personnel Management (OPM), or a DoD-determined equivalent investigation. The issuance of a CAC will be based on four criteria; (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-1, Personal Identity Verification (PIV) of Federal Employees and Contractors, March 2006, and DOD

Regulation 5200.2-R, Department of Defense Personnel Security Program, January 1987, and (d) verification of a claimed identity. CAC eligible personnel must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either an authoritative personnel data feed from the appropriate Service or Agency or Trusted Associate Sponsorship System (TASS).

HSPD-12 Background Investigation Requirements: The contractor ensures Common Access Cards (CACs) are obtained by all contract or subcontract personnel assigned to work on the Government site and by personnel requiring access to a DoD network (and other eligible populations as specified in DTM-08-003 Attachment 3, paragraph 3a.).

Personnel at a minimum, should (will) receive a favorable FBI fingerprint check and must submit to the Office of Personnel Management (OPM) a National Agency Check with Inquiries (NACI) or equivalent/higher investigation. The contractor will ensure contractor employees meet CAC eligibility standards upon assignment to the contract and shall (will) be held responsible for delays, failure to meet performance requirements, or decreases in efficiency in accordance with the applicable inspection clause.

Trusted Associate Sponsorship System (TASS): The contractor is responsible for processing applications for Common Access Cards (CAC) for every contractor employee who deploys with the military force OR who has need to access any government computer network in accordance with FAR 52.204-9, "Personal Identity Verification of Contractor Personnel." The contractor is responsible for managing requests for new, or the renewal, of CAC cards in sufficient time to ensure all contractor employees have them when needed to perform work under this contract. The norm is at least ten calendar days advance notice to the Trusted Agent (TA), unless there are extenuating circumstances approved by the Contracting Officer's Representative (COR) or Contracting Officer. It is recommended that a "Corporate Facility Security Officer" (FSO) be designated to serve as your firm's single point of contact for Background Investigation (BI), the TASS application process and other CAC and security related matters. If a FSO is not established, each contractor employee requiring a CAC will be required to process their own applications. CAC applications shall be processed through the TASS. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA) before accessing the TASS website. The TASS TA for this requirement will be: The government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and Password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) https://www.dmdc.osd.mil/tass/.

The FSO or contractor employee will submit completed applications in TASS and will follow up to ensure the TA is processing the request. A CAC cannot be issued without evidence the FSO has initiated a National Agency Check with Written Inquires (NACI).

Responsibility to complete a NACI will be on the contractor. The government will inform the contractor's applicant, via email, of one of the following: Approved.* Upon approval, the information is transferred to the Defense Enrollment Eligibility Reporting System (DEERS) database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a Real- Time Automated Personnel Identification System (RAPIDS) station (RAPIDS Site Locator:

http://www.dmdc.osd.mil/rsl/).

Rejected.* The Government, in separate correspondence, will provide reason(s) for rejection. Returned. Additional information or correction to the application required by the contractor employee.* the contractor shall maintain records of all approved and rejected applications. At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor by SSN and two forms of identification. Identity source Documents must come from the list of acceptable documents included in Form I-9, OMB No. 115-0136, "Employment Eligibility Verification." Consistent with applicable law, at least one document from the Form I-9 list shall be a valid (unexpired) State or Federal Government-issued picture identification (ID). The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS and will then issue a CAC. Issued CACs shall be for a period of performance not longer than three (3) years or the individual's contract end date (inclusive of any options), whichever is earlier. The contractor shall return issued CAC's to the COR/KO office upon departure or dismissal of each contractor employee.

Obtain a receipt for each card.

Gate closures: Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contract personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee's installation driving privileges.

Base Regulations: The contractor's employees shall become familiar with and obey the regulations on the installation; including fire, traffic, safety and security regulations while on the installation. Contract employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance.

AT Level 1 Awareness Training (AT): This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 30 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: http://jko.jten.mil.

Access and general protection/security policy and procedures. This standard language is for contractor employees with an area of performance within Army controlled installation, facility, or area. Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non- DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management.

iWATCH Training. This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 30 calendar days of contract award and within 5 calendar days of new employees commencing performance with the results reported to the COR NLT 30 calendar days after contract award.

Army Training Certification Tracking System (ATCTS) registration for contractor employees who require access to government information systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

For contracts that require OPSEC Training. Per AR 530-1 Operations Security, the contractor employees must complete Level I OPSEC Awareness training. New employees must be trained within 30 calendar days of their reporting for duty and annually thereafter.

For information assurance (IA)/information technology (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoD 8570.01, DoD 8570.01-M and AR 25-2 within six months of appointment to IA/IT functions.

Threat Awareness Reporting Program. For all contractors with security clearances. Per AR 381-12 Threat Awareness and Reporting Program (TARP), contractor employees must receive annual TARP training by a CI agent or other trainer as specified in 2-4b.

COMSEC/IT Security: All communications with DoD organizations are subject to communications security (COMSEC) review. All telephone communication networks are continually subject to intercept by unfriendly intelligence organizations. DoD had authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DoD organizations. Therefore, the contractor is advised any time contractor places or receives a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DoD information.

The contractor shall (will) abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

Government Systems and Networks: Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the AEI. Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall: comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation. Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil). Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know. Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements. Practice safe network and Internet operating principles and take no actions threatening the integrity of the system or network.

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

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

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

Data Rights: Once a computer has joined the Nebraska Guard Net all information falls under the control of Nebraska Information Assurance Policy and all rights are reserved by the NE National Guard.

• Recognized Holidays: The following are recognized US holidays. Military personnel are typically not available during these dates unless mission critical events (i.e. Pre-Deployment Health Assessments) are occurring. The contractor should be able to support any mission critical events and is therefore available 365 calendar days a year and is available to perform services on days:

• New Year's Day: January 1st

• Martin Luther King, Jr.'s Birthday

• President's Day

• Memorial Day

• Independence Day: July 4th

• Labor Day

• Columbus Day

• Veteran's Day: November 11th

• Thanksgiving Day

• Christmas Day

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.

Business Relations: The contractor shall successfully integrate and coordinate all activity 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. The contractor shall seek to ensure customer satisfaction and professional and ethical behavior of all contractor personnel.

Contract Administration and Management

• 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 at NE ARNG Medical Detachment and the contractor's corporate offices.

• 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 the contract. The contractor shall assign work effort and maintaining proper and accurate time keeping records of personnel assigned to work on the requirement.

• Personnel Administration: The contractor shall provide the following management and support as required. The contractor shall provide for employees during designated Government non-work days or other periods where Government offices are closed due to weather or security conditions. The contractor shall maintain the currency of their employees by providing initial and refresher training as required to meet the PWS requirements. The contractor shall make necessary travel arrangements for employees.

The contractor shall provide necessary infrastructure to support contract tasks. The contractor shall provide administrative support to employees in a timely fashion (time keeping, leave processing, pay, emergency needs).

Subcontract Management: Organization Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g. cost or pricing information, budget information or analyses, specifications or work statement, etc.). Or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or mitigate any such OCI. The contractor's mitigation plan will be determined to be acceptable solely at the discretion of the KO and in the event the KO unilaterally determines any such OCI cannot be satisfactorily avoided or mitigated, the KO may affect other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

Contractor Personnel, Disciplines, and Specialties: The contractor shall (will) accomplish the assigned work by employing and utilizing qualified personnel with appropriate combinations of education, training, and experience. The contractor shall (will) match personnel skills to the work or task with a minimum of under/over employment of resources. The contractor shall (will) ensure the labor categories as defined in the Labor Categories document (see attachment) utilized in the performance of the contract issued hereunder will be the minimum necessary to accomplish the task.

The Contractor shall (will) provide the necessary resources and infrastructure to manage, perform, and administer the contract.

Location and Hours of Work: Accomplishment of the results contained in this PWS requires work at the NE ARNG Medical Detachment (2400 NW 24th Street, Lincoln NE 68524). Normal workdays are Monday through Friday except US Federal Holidays.

Contractors are allowed to work whenever NEARNG government employees are present. This typically occurs between the hours of 7:30am - 4pm. Representatives for medical records will be present during core hours of work are from 0900 to 1500 daily.

Contractor may be asked to support PHA/SRP events occurring on weekends. Typical work hours for weekend duty is between 7:30am - 4pm. Longer work periods may be required during Remote Operations and to meet other surge requirements.

Telework will only be available in case of a pandemic, natural disaster and/or any state of emergency that would require the closing of the facility. Telework will only be authorized if there is no additional cost to the government. If the employee uses Government-furnished equipment (GFE), the employee will use and protect the equipment in accordance with the DoD Component's procedures. GFE will be serviced and maintained by the Government. For Official Use Only (FOUO) and controlled unclassified information (CUI) data may be taken to alternative worksites if necessary precautions are taken to protect the data, consistent with DoD regulations. When CUI including competition sensitive or source selection data is authorized for use at the telework location, criteria for the proper encryption and safeguarding of such information and data.

5.0 Special Requirements

6.0 Security and Safety

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.

Safety: Contractor Compliance: The contractor and its subcontractors shall comply with Public Law 91-596 (Occupational Safety and Health Act (OSHA)) and the Environmental, Safety, and Occupational Health (ESOH) (DODD 4715.1E). These requirements shall be incorporated into the contractor's safety and health program. The Department of Defense (DoD) participates in the OSHA Voluntary Protection Program (VPP). Contractor personnel performing services on a DoD installation shall participate in the local VPP. Information on the VPP is available at http://www.osha.gov/dcsp/vpp/index.html. Mishap Notification and Investigation: The contractor and its subcontractors (if applicable) shall promptly report pertinent facts regarding mishaps involving Government property damage or injury to Government personnel and to cooperate in any resulting safety investigation. The contractor shall notify (via telephone) the cognizant contracting officer, the contracting officer's representative, and/or other applicable members within four (4) hours of all mishaps or incidents. The Government person notified by the contractor will in-turn notify the Safety office. Contractor notifications made after duty hours shall be reported to the appropriate installation Command Post. If requested by the cognizant contracting officer, the contracting officer's representative, and/or the cognizant program manager, the contractor shall immediately secure the mishap scene/damaged property and impound pertinent maintenance and training records until released by the investigating safety office. If the Government investigates the mishap, the contractor and the subcontractors shall cooperate fully and assist the Government personnel until the investigation is completed.

7.0 Government Furnished Property: None.

FAR 45.000(b)(5) Government property that is incidental to the place of performance, when the contract requires contractor personnel to be located on a Government site or installation, and when the property used by the contractor within the location remains accountable to the Government. Items considered to be incidental to the place of performance include, for example, office space, desks, chairs, telephones, computers, and fax machines.

Utilities: All utilities associated with normal office environment will be provided including access to internet, electricity, water, and rest rooms.

8.0 Quality: This section describes the Quality Control components for this effort. The following sub-sections provide details of various considerations on this effort.

8.0.1 Quality Control: The Contractor shall develop a Quality Control Plan (QCP) and maintain an effective quality control program to ensure services are performed in accordance with the PWS. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The Contractor's

QCP is the means by which he assures himself that his work complies with the requirement of the contract.

The finalized QCP will be accepted by the Government at the time of the award of the contract. The Contracting Officer may notify the Contractor of required modifications to the plan during the period of performance. The Contractor then shall coordinate suggested modifications and obtain acceptance of the plan by the Contracting Officer.

Any modifications to the program during the period of performance shall be provided to the Contracting Officer for review no later than 10 working days prior to effective date of the change. The QCP shall be subject to the Government's review and approval. The Government may find the QCP "unacceptable" whenever the Contractor's procedures do not accomplish quality control objective(s). The Contractor shall revise the QCP within 10 working days from receipt of notice that QCP is found "unacceptable."

8.0.2 Quality Assurance Surveillance Plan (QASP): The Government shall monitor the Contractor's performance in accordance with the Government's QASP.

GLOSSARY

ACRONYM MEANING

APRC Army Personnel Record Center

AR Army Regulation

AT Awareness Training

ATCTS Army Training Certification Tracking System

BI Background Investigation

CAC Common Access Card

COR Contracting Officer's Representative

DEERS Defense Enrollment Eligibility Reporting System

DOD Department of Defense

DTM Directive Type Memorandum

EHR Electronic Health Record

FPCON Force Protection Condition

FSO Facility Security Officer

HRR Health Readiness Record

IAW In Accordance With

MR Medical Record

NACI National Agency Check with Inquiries

NEARNG NEbraska ARmy National Guard

OPM Office of Personnel Management

OPSEC Operation Security

PHI Protected Health Information

PII Personally Identifiable Information

PIV Personal Identity Verification

PPOM Personnel Policy Operational Message

QASP Quality Assurance Survellance Plan

RAPIDS Real‐Time Automated Personnel Identification System

SOP Standard Operating Procedure

SSMO State STR Maintenance Office

STR Service Treatment Record

TA Trusted Agent

TARP Threat Awareness Reporting Program

TASS Trusted Associate Sponsorship System