Case_Management_PWS1.docx

1. General: This is a non-personnel services contract to provide Nonclinical Case Management Services Support. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

2. Background: The Department of Defense (DoD) TRICARE Management Activity (TMA) values all staff involved in the delivery of high-quality care to service members. In 2009, a Medical Management Guide was issued by the Office of the Assistant Secretary of Defense for Health Affairs (ASD [HA]) and TMA, Office of the Chief Medical Officer (OCMO), Population Health and Medical Management Division (PHMMD). The Guide covers the components of a Medical Management (MM) program, including applicable principles, implementation concepts, processes, and tools/databases for Utilization Management (UM), Case Management (CM), and Disease Management (DM). It complements the 2001 DoD Population Health Improvement Plan and Guide published by TMA and the Government Printing Office. Under legislative mandates, the ASD (HA) submitted an annual report to Congress regarding healthcare delivery for Military Health System (MHS) beneficiaries. The 2009 report documented the MHS goal to providing high-quality care, improving performance through clinical and process outcomes, and increasing patients’ confidence in the care they receive. The Guide describes crucial components of MM within the MHS, including the link between MM and population health and the dynamics between UM, CM and DM in helping reduce unnecessary or inappropriate services and/or duplication of services. In the military setting, Case Management targets Service Members and beneficiaries with complex, multi-system healthcare needs who require care coordination or case management services. Originally, Case Management almost exclusively targeted in-patients with catastrophic illnesses or injuries. However, a number of developments have served to change that strategy; notably:

- The emergence of the National Committee for Quality Assurance (NCQA): http://www.ncqa.orgorg/

- The development of accreditation standards by the Utilization Review Accreditation Commission (URAC): http://www.urac.org.

3. Scope: To provide Medical and Dental Non-clinical Case Management and administrative Care Coordinator staffing in support of Individual Medical Readiness (IMR). This requirement is designed to be flexible, responsive, and meets the ever-evolving needs of the government. DoD Instruction (DoDI) 6025.19 establishes aggressive quarterly and annual metric goals for the separate IMR elements and for the overall IMR category of Fully Medically Ready (FMR) soldiers. The ultimate goals are to produce real-time reports based on complete, accurate data. The minimum goal for overall medical readiness is more than 75% of Service members FMR, with the ideal goal being 100%. The Virgin Islands Army National Guard (VIARNG) Surgeon’s Office requires a highly responsive process whereby the government can quickly obtain needed support and services. This PWS reflects existing National Guard Bureau (NGB) policies and regulations.

4. Special Qualifications: The non-clinical case nurse manager requires the expertise as dictated by the “practice of nursing” - the systematic application of substantial specialized knowledge and skills derived from the biological, physical, and behavioral sciences, to the care, treatment, counsel, and health teaching of individuals who are experiencing changes in the normal health processes or who require assistance in the maintenance of health and the prevention or management of illness, injury, or disability. Personnel will be experienced in all aspects and qualified in their respective functional areas. Contactor personnel shall not perform inherently governmental functions (i.e., representation of government, decision authority, etc.).

5. Tasks: The following services are required to successfully deliver the objectives. Services are to be performed in accordance with the highest professional standards and the following requirements:

· Responsible for tracking medical status of ALL assigned Soldiers.

· Responsible for medical charting in e-Case

· Request profile exams/evaluations and audiology exams at physical exam center

· Coordinate Soldier treatment plans with appropriate medical facilities.

· Maintain automated referrals indicated in MEDCHART.

· Submit case processing, medical documentation, and profile concerns to military/contacted provider.

· Attend PHA events as determined by the needs of the state and the individual units.

· Ensure those Soldiers referred by a provider are followed by the case management team.

· Manage Soldier’s care from the identification of the condition to when the Soldier is either:

- Considered medically ready.

- Administratively separated from the military.

· Follow the regulations and policies applicable to Individual Medical Readiness (IMR) and deployment, to include the AR 40-501 and other applicable guidance.

· Ensure all medical documentation received from the Soldier and/or their medical team is received and placed in appropriated electronic record, as well as the Soldier’s hard copy record.

· Maintain Soldier medical records in accordance with Army Regulation (AR) 40-66

· Provide Records Custodian or delegate with all relevant medical/dental documentation.

· Obtain release of information from Soldier

· Educate Soldiers on resources available to improve medical and dental readiness

· Maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines

· Review and track health assessment (PHA, SRP) lab results contact SM and educate on lifestyle modifications.

· Upload medical documents of case managed Soldiers into Health Readiness Record (HRR).

· Stamp all medical documents for verification after uploading.

· Index uploaded medical documents.

· MODS entry of immunizations, designation of pregnancy, eye exams, medical warning tags.

· Provide all medical documents received for case management to Records Custodian to be filed using a document evidencing transfer of custody from the contractor to the government. Copy of each supporting transfer document shall be provided to the COR at the end of each month no later than 7 calendar days at the end of the month.

· Contractor will ensure all administrative charting in e-Case is completed.

· Track medical appointments by communication with unit to ensure Soldier attendance and submission of follow up documentation.

· Log in e-Case any contact with SM (email, voice call, or personal interview).

· Communicate with delegated government personnel to track compliance versus noncompliance.

· Run MEDPROS report Post PHA/SRP event

· Monitor MEDPROS to ensure all scheduled services are completed /updated and current medical status is reflected.

· Report Medical Readiness to the Commander or his/her designated representative.

· Ensure Soldiers with T3, T4, P3 or P4 profiles are case managed in the e-Case module.

6. Quality Control: The contractor shall develop and maintain an effective quality control program (QCP)to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control program is the means by which he assures himself that his work complies with the requirement of the contract. The QCP is to be delivered, i.e., within 30 days after contract award. Three copies of a comprehensive written QCP shall be submitted to the contract officer (KO) and Contracting Officer Representative (COR) within 5 working days when changes are made thereafter. After acceptance of the quality control plan the contractor shall receive the contracting officer’s acceptance in writing of any proposed change to his quality contract system.

7. Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

8. Recognized Federal Holidays: Contractor may be required to provide services on weekends, holidays, after working hours for scheduled unscheduled appointments/events, and for emergencies as needed and as dictated by circumstances.

The contract worker must obtain the approval of the contractor with respect to local and administrative holidays observed by the Virgin Islands National Guard.

9. Hours of Operation: The contractor is responsible for conducting business 8 hours per week, between the hours of 8:00 a.m. to 5:00 p.m., not including Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings, except as noted in number 14 above. The above notwithstanding, standard core hours for all contractor personnel shall conform to the customer agency normal working hours and days. Variation may be required in order to accomplish assigned tasks. Overtime, however, is not authorized. Part time employees, whose normal work day falls on a holiday, will adjust their schedule to work on another day during that work week.

For other than firm fixed price contracts, the contractor will not be reimbursed when the government facility is closed for the above reasons. The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

10. Place of Performance: The work to be performed under this contract will be performed at the Virgin Islands National Guard, #1 Estate Sprat Hall, Frederiksted, VI 00840 and at any Virgin Islands National Guard facility within the Territory, or as otherwise assigned for temporary duty leave (TDY).

The Contract employees may be required to travel to execute any missions to support and augment the ARNG consistent with all services described within the PWS. Specifically, in the event of a mobilization event, the Contractor shall ensure adequate support is available for travel to locations to best support these activities (i.e. work at armories) as directed by the Contracting Officer. If changes to the original work in this PWS arise during the performance of the contract, the COR will notify the KO. If determined to be within the scope of the contract the KO will provide 30 calendar day notice to the contractor with full description of the need and request a proposal. The KO will negotiate a modification to the contract to provide this in-scope work effort. Travel to and from the primary worksite will not be reimbursed.

Unscheduled gate closures by the Security Guard 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 contractor 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.

The contractor’s employees shall become familiar with and obey the regulations of the installation including fire, traffic, safety and security regulations while on the installation. Contractor 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.

· Antiterrorism/Operations Security Requirements

· AT Level I Training. 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 KO, if a COR is not assigned, within 45 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. Contractor and all associated sub-contractors employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also 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 as directed by DoD, Headquarters Department of the Army (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.

· iWATCH Training. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity Antiterrorism Officer). 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 15 calendar days of new employees commencing performance with the results reported to the COR NLT 45 calendar days after contract award.

· 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 information systems and then annually thereafter.

· OPSEC Training. Per AR 530-1, Operations Security, new contractor employees must complete Level I OPSEC training within 30 calendar days of their reporting for duty. All contractor employees must complete annual OPSEC awareness training.

· 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 employment.

· Handling or Access to Classified Information. Contractor shall comply with FAR 52.204-2, Security Requirements. This clause involves access to information classified “Confidential,” “Secret,” or “Top Secret” and requires contractors to comply with— (1) The Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (DoD 5220.22-M); any revisions to DOD 5220.22-M, notice of which has been furnished to the contractor.

· Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor shall also 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. The contractor shall ensure compliance with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

· COMSEC/IT Security. All communications with DOD organizations are subject to communications security (COMSEC) review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DOD has 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 place or receive 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 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.

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 contractor’s 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.

· CAC Requirements: The Common Access Card (CAC) is the 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 ensure 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.) are required to, at a minimum, have received a favorable FBI fingerprint check and must have submitted to the Office of Personnel Management (OPM) a National Agency Check with Inquiries (NACI) or equivalent/higher investigation. It is the responsibility of the contractor to ensure all employees requiring an initial background investigation complete a Personnel Security Investigation Portal (PSIP) form, at the earliest possible date, and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward to the NGB Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm the request has been received by the Office of Personnel Management, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e-QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the BI will be initiated. The contractor shall ensure all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system are complied with immediately. The contractor is cautioned the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from 2-6 weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure contractor employees meet CAC eligibility standards upon assignment to the contract and shall 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 renewal 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 COR or KO. It is recommend 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). 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.

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.

AT Level 1 Awareness Training (AT). The service provider is required to complete the Level 1 Awareness Training in order to gain access to VING’s network. The training can be found at https://atlevel1.dtic.mil/at/.

11. Security Requirements: Contractor personnel performing work under this contract must obtain a NACI level of security within 30 days after contract award, and must maintain the level of security required for the life of the contract. They will meet the requirements to obtain a Common Access Card (CAC) for Local Access Network and for identification. The security requirements are in accordance with DD254. (The unit security monitor is responsible for initiating this form).

12. Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

13. Key Control. The Contractor shall establish and implement methods of making sure all keys/key cards, if required issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE: All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated. The Contractor shall develop procedures covering key control that shall be included in the Quality Control Plan. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The Contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the KO.

In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the KO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

The Contractor shall prohibit the use of government issued keys/key cards by any persons other than the Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the KO.

14. Lock Combinations. The Contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The Contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the Contractor’s Quality Control Plan.

15. Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The KO, COR, and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the KO will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

16. Contracting Officer Representative: The COR will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions:

A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

17. Key Personnel: The contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between 8:00 a.m. to 5p.m. Monday thru Friday except Federal holidays or when the government facility is closed for administrative reasons.

18. Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed. Contractor personnel are required to have VING-issued identification on their person at all time and displayed in compliance per VING policy.

Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions will be taken against employees for violations of this policy. Such actions may include, but are not limited to, removal from the contract, reduction in benefits, or termination of employment. The Contractor shall take appropriate action, up to and including termination, against employees or subcontractors violate the US Government policy as described at FAR 22.17.

19. Contractor Travel: Contractor will be required to travel CONUS and OCONUS during the performance of this contract to attend meetings, conferences, training, and to deliver services. The contractor may be required to travel to off-site training locations and to ship training aids to these locations in support of this PWS. Contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires Government approval/authorization and notification to the COR.

20. Other Direct Costs (If applicable): Should travel become necessary, it will be performed only after written approval is received by the COR. Travel will be performed on a cost reimbursable basis in accordance with federal and DoD Joint Travel Regulations. Travel is not to exceed the limitation of funds specified in this contract.

21. Data Rights: The Government has unlimited rights to all documents/material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government.

These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

22. Organizational Conflict of Interest: Contractor and subcontractor personnel performing work 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 statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer 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 that 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.

23. Deliverables: The contractor shall prepare and deliver the following items to the VIRGIN ISLANDS NATIONAL GUARD State Surgeon or his or her designated representative:

Nurse Practitioner:

DELIVERABLE

ACCEPTABLE QUALITY LEVEL (AQL)

METHOD USED / FREQUENCY

Narrative summary

(NARSUM)

24. Contractor Manpower Reporting Application (CMRA): Section 2330a of title 10, United States Code (10 USC 2330a), requires the Secretary of Defense to submit to Congress an annual inventory of contracts for services performed during the prior fiscal year for or on behalf of the DoD. The inventory must include the number of contractor employees using direct labor hours and associated cost data collected from contractors.

The contractor is required to register at https://cmra.army.mil. The data must be entered into the CMRA database after the completion of the fiscal year. The deadline to enter data is 31 October.

The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Virgin Islands National Guard via a secure data collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. Contractors may direct questions to the help desk at help desk at: http://www.ecmra.mill.

25. Quality Assurance Plan (QAP): The customer Point of Contact (POC) will monitor contractor performance and complete the QAP Worksheet provided below on a monthly basis. The QAP Worksheet will be submitted directly to the Administering KO with a copy to the Schedule Holder and the COR following the first month of performance, not later than the 5th day of each month following the service. Future months will be submitted to the KO and the Schedule Holder (and the COR if involvement is warranted; i.e., other than a green rating). The COR will assume a quality performance rating of “Green” on all measured deliverables unless otherwise notified.

The quality rating may change from “Green” to “Red” without notice. We anticipate the POC utilizing the “Yellow” quality rating to alert the contracting office and the COR of quality issues that have the potential for a “Red” quality rating if corrective action is not taken.

At the end of the task order period of performance or annually, the POC will be asked to complete a Quality Performance Review to document the quality performance rating during the performance period. This will be submitted to the KO and the COR.

The POC may submit a QAP Worksheet at any time and as often as necessary to document quality levels. If contractor response to an identified quality deficiency is unsatisfactory, the KO or COR will contact the appropriate contractor representative to implement a plan of action to remedy the identified deficiency.

Unless a task order COR has been formally trained (requires a 40 hour course, proof of training certification is required), the COR referred to in this QAP is LTC Jean Collins, Email jean.v. movingcollins.mil@mail.mil, Tel (340) 201-9814. The POC for this task order is SSG Donna Prockledger, Email: donna.r.prockledger.mil@mail.mil Tel (340) 712-7856 and MAJ Geraldine P. Vaval, email: geraldine.p.vaval.mil@mail.mil, Tel (340) 712-7831.

26. VIARNG Surgeon’s Office requires both case manager and administrative care coordinator support services. The case management position must be filled by a Registered Nurse (RN).

27. The Contractor shall furnish all labor and services required to provide a wide range of Medical and Dental Non-clinical Case Management and related Medical Administrative support services.

28. Period of Performance: The period of performance shall be 15 June 2015 to 14 June 2016. This requirement will be awarded as a time and materials contract, not Firm Fixed Price (FFP) and Performance Statement of Work-based. While Case Management continues to focus on catastrophic illness or injury, Case Management practices are also intensely directed at addressing chronic conditions that are more prevalent in the general patient population. Case managers can affect patient outcomes through proactive interventions across multiple healthcare settings. Additionally, case managers are expected to engage community resources and facilitate ongoing and consistent patient education.

The MHS has three primary goals for Case Management:

Soldier requires complex care.

- Evaluate the impact of case management on the quality of military health care.

On 29 March 2012, the ARNG achieved the Department of Defense (DoD) goal of 75% Fully Medically Ready (FMR) Soldiers per DoD Instruction (DoDI) 6025.19, Individual Medical Readiness (IMR). This monumental accomplishment marked the highest medical readiness percentage the ARNG has achieved in documented history. Over the past year, ARNG readiness has continued to increase to over 80%. Continued utilization of medical case managers is essential to maintaining established medical readiness goals for the ARNG.

Quality Assurance Surveillance Plan (QASP)

1.0 Background: The Department of Defense (DoD) TRICARE Management Activity (TMA) values all staff involved in the delivery of high-quality care to service members. In 2009, a Medical Management Guide was issued by the Office of the Assistant Secretary of Defense for Health Affairs (ASD [HA]) and TMA, Office of the Chief Medical Officer (OCMO), Population Health and Medical Management Division (PHMMD). The Guide covers the components of a Medical Management (MM) program, including applicable principles, implementation concepts, processes, and tools/databases for Utilization Management (UM), Case Management (CM), and Disease Management (DM). It complements the 2001 DoD Population Health Improvement Plan and Guide published by TMA and the Government Printing Office http://www.tricare.mil/ocmo/download/mhs_phi_guide.pdf.

1.1 Under legislative mandates, the ASD (HA) submitted an annual report to Congress regarding healthcare delivery for Military Health System (MHS) beneficiaries. The 2009 report documented the MHS goal to providing high-quality care, improving performance through clinical and process outcomes, and increasing patients’ confidence in the care they receive. The Guide describes crucial components of Medical Management within the MHS, including the link between MM and population health and the dynamics between Utilization Management, Case Management and Disease Management in helping reduce unnecessary or inappropriate services and/or duplication of services. In the military setting, Case Management targets Active Duty Service Members and beneficiaries with complex, multi-system healthcare needs who require care coordination or case management services.

1.1.1. Originally, Case Management almost exclusively targeted in-patients with catastrophic illnesses or injuries. However, a number of developments have served to change that strategy; notably: - The emergence of the National Committee for Quality Assurance (NCQA): http://www.ncqa.orgorg/ and the development of accreditation standards by the Utilization Review Accreditation Commission (URAC): http://www.urac.org. While Case Management continues to focus on catastrophic illness or injury, Case Management practices are also intensely directed at addressing chronic conditions that are more prevalent in the general patient population. Case managers can affect patient outcomes through proactive interventions across multiple healthcare settings. Additionally, case managers are expected to engage community resources and facilitate ongoing and consistent patient education.

1.1.2 The MHS has three primary goals for Case Management:

· Improve the care, management, and transition of recovering Service members.

· Broaden the application of CM to include those with complex and at-risk needs before the Soldier requires complex care.

· Evaluate the impact of case management on the quality of military health care.

The Army National Guard, recognizing the importance of Medical Readiness after several years of combat deployments, implemented the Case Manager Support Contract in August 2005 as a time and materials contract, not Firm Fixed Price (FFP) and Performance Statement of Work-based. The current contract was originally awarded August 2009 to Skyline Ultd (with 49% subcontract to Sterling Medical). At the end of FY09, case managers in 31 states were using the medical non-deployable module to manage their case loads. During the period of August 2008 to August 2009, 15,292 cases were put into the module; of these, 6734 were closed by return to duty, fit for duty, or forwarded for an MEB/PEB evaluation. Additionally, readiness increased from 35% fully-ready in FY08 to 44% in FY09. This success resulted from increased targeted funding and a concerted effort by the National Guard Bureau. On 29 March 2012, the ARNG achieved the Department of Defense (DoD) goal of 75% Fully Medically Ready (FMR) Soldiers per DoD Instruction (DoDI) 6025.19, Individual Medical Readiness (IMR). This monumental accomplishment marked the highest medical readiness percentage that the ARNG has achieved in documented history. Over the past year, ARNG readiness has continued to increase to over 80%. Continued utilization of medical case managers is essential to maintaining established medical readiness goals for the ARNG.

- Vision: Provide a healthy, resilient, ready and deployable force for federal, state and community missions

- Mission: To Provide a Responsive Medical Force and a Healthy Medically Ready Army National Guard

- Support deployment of a healthy force – Soldiers

- Support deployment of the medical force – Units

- Facilitate Warriors in Transition and Family Care – Beneficiaries

2.0 Purpose: This Quality Assurance Surveillance Plan is a government-developed document used to determine if the contractor’s performance meets the performance standards contained in the contract. The QASP establishes procedures on how this assessment/inspection process will be conducted. It provides the detailed process for a continuous oversight process:

- What will be monitored

- How monitoring will take place

- Who will conduct the monitoring

- How monitoring efforts and results will be documented

2.1 The contractor is responsible for implementing and delivering performance that meets contract standards using its Quality Control Plan. The QASP provides the structure for the government’s surveillance of the contractor’s performance to assure that it meets contract standards. It is the government’s responsibility to be objective, fair and consistent in evaluating contractor performance.

2.2 The QASP is not part of the contract nor is it intended to duplicate the contractor’s quality control plan. This QASP is a living document. Flexibility in the QASP is required to allow for an increase or decrease in the level of surveillance necessary based on contractor performance.

2.3 The government may provide a copy of the QASP to the contractor to facilitate open communication. In addition, the QASP should recognize that unforeseen or uncontrollable circumstances might occur that are outside the control of the contractor.

2.4 Bottom line, the QASP should ensure early identification and resolution of performance issues to minimize impact on mission performance.

2.4.1 Authority

Authority for issuance of this QASP is provided under Part 46 of the Federal Acquisition Regulation, Inspection of Services clauses, which provide for inspection, acceptance and documentation of the service called for in the contract or order. This acceptance is to be executed by the contracting officer or a duly authorized representative.

2.4.2 Roles and Responsibilities

The following personnel shall oversee and coordinate surveillance…