Amd_01_W9128F19Q0097,_EAP_Services.pdf

W59XQG91503719

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

Attachment 3/Technical Exhibit 3 – Estimated Workload Data located in the Performance Work Statement (PWS) updated to match the Employee Count located in Paragraph 1.4.2 of the PWS.

Offers due Date/Time extended to 24 JUN 19 / 12:00 PM

1. CONTRACT ID CODE PAGE OF PAGES

J 1 20

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 20-Jun-2019

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W9128F19Q0097

X 9B. DATED (SEE ITEM 11)

13-Jun-2019

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X is extended, is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO.

5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

20-Jun-2019

CODE

U.S. ARMY CORPS OF ENGINEERS, OMAHA DIST

CONTRACTING OFFICE

1616 CAPITOL AVENUE

OMAHA NE 68102-4901

W9128F 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W9128F19Q0097

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SOLICITATION/CONTRACT FORM

The required response date/time has changed from 20-Jun-2019 02:00 PM to 24-Jun-2019 12:00 PM.

The following have been modified:

PERFORMANCE WORK STATEMENT

CENWO-CT PERFORMANCE WORK STATEMENT (PWS)

Employee Assistance Program

20 June 2019

PART 1

GENERAL INFORMATION

1. General: This is a non-personnel services contract to provide the services of a qualified Assessment and Referral Resource Firm for the Employee Assistance Program to the U.S. Army Corps of Engineers, Omaha District (to include Field Offices). These services will include but not be limited to EAP implementation, intake interviews, problem assessment, short term counseling, referral to treatment agency, follow up to determine rehabilitation rate, record keeping, training for supervisors and when requested provide on a cost reimbursable bases, conducts training for District employees on topics such as workplace violence, suicide prevention and other tailored training that contributes to the overall welfare of the workforce.

The Government shall not exercise any supervision or control over the subcontract 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.

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform Employee Assistance Program (EAP) services to the Army Corps of Engineers, Omaha District to include all Field Offices as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

1.2 Background: Federal Employee Health Services Programs, 42. U.S.C. provides that Federal agencies shall be responsible for developing and maintaining appropriate prevention, treatment, and rehabilitation programs and services for Federal civilian employees with alcohol or drug related problems. Guidance for implementing these requirements is contained in Title 5 CFR, Part 792. Executive Order 12564 dtd 15 September 1986 established further requirements for Federal agencies and employees in order to obtain a drug-free Federal workplace, Army Regulation 600-85, dtd 28 November 2016, Engineer Regulation 690-1-710, dtd 29 June 2012 state that an EAP will be established to provide assistance to all employees.

The range of problems to be covered may include any emotional/behavioral problems including, but not limited to alcoholism, drug abuse, emotional and family stress, financial, legal, and marital problems.

1.3 Objectives:

1.3.1 Employee assistance implementation

1.3.2 Training/program orientation for supervisors, equal employment opportunities and civilian personnel office employees.

Initial intake interview Problem identification/assessment Short term counseling/treatment Referrals Follow-up to determine rehabilitation rate Record keeping Quarterly reports to the Contracting Officer’s Representative.

1.4 Scope: Contractor shall provide:

1.4.1 Problem identification, intake, preventive counseling and referral for treatment, rehabilitation, or any other assistance for federal civilian employees/family members with medical, emotional, financial, or interpersonal problems, alcohol abuse, and drug dependency;

1.4.2 Counseling and referral services to employees/family members at the following locations:

Nebraska – Omaha (801) Wisconsin – Ft. McCoy, near Tomah (10) South Dakota – Pickstown (56), Pierre (62), Yankton (69), Rapid City (28) &

Chamberlain (41) North Dakota – Garrison (73) Montana – Helena (10) and Ft. Peck (47) Wyoming – Cheyenne (5) Colorado – Colorado Springs (50), Denver (43) and Littleton (7)

1.4.3 Counseling and referral to employees who; test positive for drugs, face discipline for misconduct or unacceptable performance, are having interpersonal conflicts, are dealing with stress, or attendance issues;

1.4.4 Responses to crisis situations that have a negative impact on emotional wellness in the organization such as violence in the workplace, suicide attempts or threats of suicide, grief counseling upon the death of a co-worker, family member, and loss of job through reduction-in-force (RIF).

1.4.5 The contractor shall perform risk assessment, provide short-term counseling services (up to three one-hour counseling sessions per problem), provide aftercare and follow-up services to program participants to include monitoring progress.

1.4.6 The contractor shall maintain, manage, and secure confidential records in accordance with Federal Employees Health Services Programs, 5 CFR 792, as well as 42 CFR Part 2. The contractor shall have filing systems and equipment which insure compliance with all Department of Defense (DoD) standards related to the protection of confidential and personally identifiable information (PII) and abide by the Health Insurance Portability and Accountability Act of 1996

(HIPAA), Public Law 104-191, which establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically.

1.4.7 The contractor shall provide flyers, brochures, or electronic information for the purpose of publicizing the availability of the EAP throughout the command, in in-house publications (articles addressing but not limited to current mental health issues ranging from any emotional/behavioral problems to include alcoholism, drug abuse, emotional and family stress, financial, legal and marital problems) and for use at regularly scheduled new employee orientation, new supervisors’ training and continuing employee/supervisor training or shall provide other materials deemed necessary by the Omaha District Contracting Officer or Contracting Officer’s Representative.

1.4.8 The contractor shall develop a present annually a training model that demonstrates how its Employee Assistance Program operates. This Training Model shall explain CEAP benefits and the methods of referral. This Training Model, prepared for supervisory personnel, Equal Employment Opportunity (EEO) counselors, and personnel specialists, shall also include an interactive capability to develop and refine student skills in identifying, communicating with and referring employees who have problems which interfere with job performance, attendance, and/or conduct.

1.4.9 The contractor shall provide consultation services requested on an emergency or a routine basis either by management referral or directly by the employee as a self referral.

1.4.10 The contractor shall be qualified to perform risk assessment and referral functions for employees to identify and assess problems and refer employees to appropriate treatment facilities.

The services shall include but are not limited to:

1.4.10.1 Conducting intake interviews to identify and assess the problem.

1.4.10.2 Providing a choice of treatment options/facilities that are qualified and have demonstrated the ability to treat the problem within the provisions of the employee’s health insurance plan or ability to pay for treatment.

1.4.10.3 The contractor shall provide short term counseling services within 24 hours of request for service (unless employee requests an appointment time beyond the 24 hours).

a. The contractor shall commence risk assessments within one (1) hour of call from Omaha

District Civilian Personnel Advisory in response to management referral for last chance agreement, proposed suspension, proposed removal, fitness for duty (Risk Assessments), and threat of violence in the work place, suicide and positive drug test.

b. Oral results from the contractor are due to the Specialist one hour after completion of the risk assessment session.

1.4.11 PERFORMANCE REQUIREMENTS

The contractor must demonstrate sufficient experience providing EAP services. At a minimum, the contractor shall have been involved in EAP assessments, referrals, short term counseling, and the development of follow-up progress reports for a federal or corporate civilian population for problems and/or illnesses such as or caused by stress, marriage, family, financial, children, substance abuse, and other psychological, physical, and emotional situations.

1.4.11.1 RELEVANT EXPERIENCE

a. The key personnel for this contract are the EAP Program Manager with a staff of qualified licensed professionals who are both capable of, and available to, interface and integrate with the Omaha District civilian workforce regarding a variety of EAP-related assignments; e.g., mandatory referrals, grief counseling, group training, presenting briefs.

b. The contractor shall have a staff of qualified licensed professionals who are Counselors with Master Degrees in accordance with Office Personnel Management (OPM) Qualification Standard. The staff shall have the qualifications and demonstrated ability to identify and assess a variety of mental, physical, chemical dependency, and/or emotional problems and provide short-term counseling as required.

c. The contractor shall have facilities and staff, professional and support, to handle workload, record keeping and reporting. The contractor shall operate from its own facilities and provide maximum confidentiality for the employee and employee's records in accordance with and abide by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, which establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The HIPAA Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. Also the HIPAA rule gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.

d. The contractor and/or staff members shall respond to all request calls from locations listed in the area of coverage identified in Section 2 for assistance under this contract within sixty (60) minutes of receipt of a call between the hours of 0800 and 1700 Monday – Friday and within two (2) hours for after 1700 Monday – Friday and anytime on Saturday and Sunday.

e. The contractor shall provide 24 hour 7 days a week toll free phone line coverage by a mental health counselor.

f. The contractor shall be knowledgeable of and conversant with a broad network of treatment facilities for a variety of problems and maintain a referral roster of resources for areas of coverage.

g. The contractor shall comply with all local, state, and federal regulations and laws that apply to the work being performed under this contract.

h. All financial, statistical, personnel and technical data which is furnished, produced or otherwise available to the contractor during the performance of this contract are considered confidential business information, potentially containing confidential and/or personally identifiable information, and shall not be used for purposes other than performance of work under this contract nor be released by the contractor without prior written consent of the employee and Omaha District Contracting Officer.

1.5 Period of Performance: The period of performance shall be for one (1) Base Year of 12 months and five (4) 12-month option years.

1.6 General Information

1.6.1 Quality Control: The Prime contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS, within 30 days after contract award. Existing quality documents that meet the requirements of this contract may continue to be used. The Contractor shall also require all subcontractors to possess a quality control program commensurate with the services and supplies to be provided as determined by the Prime. At minimum, the contractor’s quality system shall meet the following key criteria:

a. Establish capable processes to insure the effective and timely delivery of EAP services.

b. Monitor and control critical process variations.

c. Establish mechanisms for feedback concerning the provision of EAP services;

d. Implement a successful root-cause analysis and corrective action system to remediate any failure in the delivery of effective and timely EAP services.

e. Establish procedures for continuous process improvement.

1.6.2 Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is attached as Technical Exhibit #1 and will be applied, quarterly or annually as stated in the plan and the minimum acceptable defect rate is also listed in the plan.

1.6.3 Recognized Holidays: Contractor is required to proved toll free phone line coverage by a mental health counselor on holidays.

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day

1.6.4 Hours of Operation: The contractor is responsible for conducting business, between the hours of 0800 and 1700 Monday – Friday and provide toll free phone line coverage by a mental health counselor on Saturdays, Sundays and holidays.

1.6.5 Place of Performance: The contractor shall operate from its own facilities and provide maximum confidentially for the employee and employee records.

1.6.6 Type of Contract: Firm Fixed Price (FFP). Purchase order

1.6.7 Security Requirements: All work performed under this contract shall be “unclassified.”

1.6.7.1 Physical Security. Contractor personnel required to physically access government facilities and projects for purposes of site visitation, supervisory and quality evaluation, or meeting attendance will comply with the latest security requirements applicable to the government facility/project.

1.6.7.2 Key Control: not applicable.

1.6.8 Special Qualifications: Counselors must be licensed, certified and or accredited. At least one counselor must be licensed to test for and diagnose alcohol and drug dependency.

1.6.9 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 contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer 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.

1.6.10 Contracting Officer Representative (COR): 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: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements. 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.

1.6.11 Key Personnel: The follow personnel are considered key personnel by the government:

Program Manager/Contract Manager/Alternate Contract Manager. 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 9:00 a.m. to 4:30p.m., Monday thru Friday except Federal holidays or when the government facility is closed for administrative reasons.

1.6.12 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.

1.6.13 Contractor Travel If travel is required by the government, it will be done on government issued invitational travel orders and the contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR). All travel requires Government approval/authorization and notification to the COR.

1.6.14 Other Direct Costs: not applicable

1.6.15 Data Rights: not applicable

1.6.16 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 Contracting Officer 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 Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer 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.

1.6.17 Phase In/Phase Out Period: not applicable.

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2. CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government.

Note: The only individual who can legally bind the government.

2.1.3. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S.

Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.5. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.6. EMPLOYEE STATUS. Verification of eligibility for service will be by the employee or by confirmation of employment status by SPAWARSYSCEN Pacific COR.

2.1.7. FAMILY MEMBER. IAW 5 CFR 630.902, family member means the employee’s spouse, or same or opposite sex domestic partner, child, parent, grandparent, grandchild, sister, or brother. Family member also means individuals in the following relationships with the employee’s spouse or domestic partner: child, parent, or grandparent. It also includes those persons in a “step” relationship and any individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship.

2.1.8. IMMEDIATE DEPENDENT. Spouse and any children under the age of 21 living with the covered civilian employee in a parent/child relationship (including adopted children, etc.) or children of any age living with the covered civilian employee in a parent/child relationship that are disabled and incapable of self support.

2.1.9. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.10. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.11. QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.12. QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.13. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.14. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.15. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.16. WORK WEEK. Monday through Friday, unless specified otherwise.

2.2. ACRONYMS:

AFARS Army Federal Acquisition Regulation Supplement AR Army Regulation CFR Code of Federal Regulations COR Contracting Officer Representative COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf DA Department of the Army DFARS Defense Federal Acquisition Regulation Supplement DOD Department of Defense FAR Federal Acquisition Regulation HIPAA Health Insurance Portability and Accountability Act of 1996 KO Contracting Officer OCI Organizational Conflict of Interest PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program TE Technical Exhibit

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: not applicable

3.2. Facilities: not applicable

3.3. Utilities: not applicable

3.4. Equipment: not applicable

3.5. Materials: not applicable

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

4.2 Secret Facility Clearance: not applicable.

PART 5

SPECIFIC TASKS

5. Specific Tasks:

5.1. Basic Services. See 1.4.1 through 1.4.11.1h above.

5.2. Task Heading. not applicable

5.3. Contractor Manpower Reporting (CMR): Contract Manpower Reporting Clause The Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the contractor will report ALL contractor manpower (including subcontractor manpower) required for performance of this contract. The contractor is required to completely fill in all the information in the format using the following web address: https://contractormanpower.army.pentagon.mil. The required information includes: (1) Contracting Office, Contracting Officer, Contracting Officer’s Technical Representative; (2) Contract number, including task and delivery order number; (3) Beginning and ending dates covered by reporting period; (4) Contractor name, address, phone number, e-mail address, identity of contractor employee entering data; (5) Estimated direct labor hours (including subcontractors); (6) Estimated direct labor dollars paid this reporting period (including subcontractors); (7) Total payments (including subcontractors); (8) Predominant Federal Service Code (FSC) reflecting services provided by contractor (and separate predominant FSC for each subcontractor if different); (9) Estimated data collection cost; (10) Organizational title associated with the Unit Identification Code (UIC) for the Army Requiring Activity (the Army Requiring Activity is responsible for providing the contractor with its UIC for the purposes of reporting this information; (11) Locations where contractor and subcontractors perform the work (specified by zip code in the United States and nearest city, country, when in an overseas location, using standardized nomenclature provided on website);

(12) Presence of deployment or contingency contract language; and (13) Number of contractor and subcontractor employees deployed in theater this reporting period (by country). As part of its submission, the contractor will also provide the estimated total cost (if any) incurred to comply with this reporting requirement. Reporting period will be the period of performance not to exceed 12 months ending September 30 of each government fiscal year and must be reported by 31 October of each calendar year. Contractors may use a direct XML data transfer to the database server or fill in the fields on the website. The XML direct transfer is a format for transferring files from a contractor’s systems to the secure website without the need for separate data entries for each required data element at the website. The specific formats for the XML direct transfer may be downloaded from the website. Attachment A (Contract Manpower Reporting Worsheet.doc) will be provided to each contractor as part of the applicable solicitation or contract and is considered part of this clause.

a. Quarterly Contract Status report: The contractor shall prepare and forward to the COR electronically, an EAP report containing the following information on a quarterly basis, ending each year with a summary report. Reports are due within two weeks following the end of the reporting period at least 95% of the time.

1) Total number of new cases.

2) Total number of reopened cases.

3) Number of alcohol cases.

4) Number of other drug cases.

5) Number of emotional and other cases.

6) Number of employees helped by counseling - client, supervisor or counselor reports that the problem was resolved and job performance is at an acceptable level, separate by client, supervisor, and counselor.

7) Number of employees not helped by counseling - the client's problem was not resolved;

performance, attendance or conduct is still unacceptable.

8) Number of employees for whom it is too early in the counseling program to judge whether they have been helped - job performance has improved but is not yet at an acceptable level, separate as reported by client, supervisor, counselor.

9) Number of self-referrals - no management action.

10) Number supervisory referrals.

11) Number of nonsupervisory employees who received Counseling and Referral Service or alcohol/drug training.

12) Number of supervisory employees who received Counseling and Referral Service or alcohol/drug training.

13) Man-hours expended on Counseling and Referral Service

14) Total number of employee cases.

15) Total number of family member cases

b. Annual status report: Same data as the quarterly report, just ending each year with a summary report: or roll up of the quarterly reports.

PART 6

APPLICABLE PUBLICATIONS

6. Publications:

6.1. The Contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures:

Federal Employee Health Services Programs, 5 CFR, Part 792 Public Law 104-191 (Health Insurance Portability and Accountability Act of 1996) Executive Order 12564, Drug Free Federal Workforce, 15 September 1986 Army Regulation (AR) 600-85, Army Substance Abuse Program, 2 Dec 2009 Engineer Regulation (ER) 690-1-710, 29 June 2012

Privacy Act of 1974

PART 7

ATTACHMENT/TECHNICAL EXHIBIT LISTING

7. Attachment/Technical Exhibit List:

7.1. Attachment 1/Technical Exhibit 1 – Performance Requirements Summary

7.2. Attachment 2/Technical Exhibit 2 – Deliverables Schedule

7.3 Attachment 3/Technical Exhibit 3 – Estimated Workload Data

ATTACHMENT 1 /TECHNICAL EXHIBIT 1

Performance Requirements Summary (PRS) The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Performance Objective Performance Standard Performance Threshold

Method of Surveillance

PRS # 1.

Intake Assessment.

-- Intake counselor(s) available M-F, 0800-1700, excluding Federal holidays.

-- New patient records created prior to first counseling session.

-- Short counseling scheduled within 24 hours unless employee request time beyond 24 hours.

-- Customer random sampling indicate high rate of satisfaction; customer complaints indicating less than satisfactory service will not exceed .05% of new cases for any given period

No deviation, from standard unless approved by COR.

Customer Feedback.

and random sampling COR keeps a customer complaint log.

PRS # 2

Individual, and family member counseling, crisis situations such as violence in the workplace, grief counseling on the death of a co-worker or loss of job through reduction in force

-- Effective assessment, diagnosis, treatment, referrals, and monitoring of progress; individual case record kept accurate and up to date.

-- 100% observance of strict confidentiality requirements.

-- Contractor provides reports to COR that meet timeliness and content.

-- Major case milestones (e.g.

completion of short term counseling services within 24 hours of request – unless employee request a time beyond 24 hrs..

-- Customer samplings & input indicate a high rate of satisfaction and less than satisfactory services will not exceed .05% of cases for any given period.

No deviation, unless approved by COR.

Customer Feedback.

and random sampling COR keeps a customer complaint log

PRS # 3

Maintained, managed and secure confidential records (Individual case files)

-- Case file initiated and maintained for all clients.

-- All records are maintained in accordance with the confidentiality requirements required by law.

No deviation unless approved by AGR

Random sampling of case files. Customer feedback.

Review complaint logs. Quality control meetings with Civilian Personal Advisory Center specialists who refer clients to counseling

PRS # 4

Materials publicizing the purpose & availability of the EAP, Command wide.

(flyers, brochures, or electronic information, in house publications)

Information available on the purpose and availability at all times and/or a quarterly newsletter is provided by email to the KO or COR.

No deviation unless approved by COR.

Audit of purpose and availably Materials & timeliness of their delivery to

COR

PRS # 5

Development of training for supervisors, equal employment opportunity (EEO) and personnel specialists.

-- No less than one training class each year, scheduled six weeks in advance.

--COR shall receive no more than two valid complaints concerning quality or presentation of training per year.

No deviation unless approved by COR.

Audits of training by COR and government conducted customer survey feedback

ATTACHMENT 2 / TECHNICAL EXHIBIT 2

DELIVERABLES SCHEDULE

Deliverable FREQUENCY # OF COPIES MEDIUM/FORM

AT

SUBMIT TO

Quarterly and Yearly Reports

Reports are submitted to the COR within two weeks following the end of the reporting period at least 95% of the time.

-- Each report containing statistical or required information is at least 98% accurate

1 copy and it may be an electronic report.

Excel spreadsheet, transmitted via e-mailed to the

COR.

Stacy.J.Dufault@ usace.army.mil

Flyer, Flyers, brochures or electronic information publicizing the availability of the EAP

Quarterly One if electronic, one per employee for hard copy.

Hard copy for wallet sized card all else should be electronic.

Stacy.J.Dufault@ usace.army.mil

Mail hard copy to: Commander Army Corps of Engineers

ATTN: CENWO-

ZS

1616 Capitol Ave

Deliverable FREQUENCY # OF COPIES MEDIUM/FORM

AT

SUBMIT TO

Omaha, NE 68102

TECHNICAL EXHIBIT 3

ESTIMATED WORKLOAD DATA

Item Name Estimated Quantity 1 State of Nebraska

Omaha employees

2 State of North Dakota Garrison (73)

3 State of South Dakota Pickstown (56), Pierre (62), Yankton (69), Rapid City (28) Chamberlain (41) employees

4 State of Colorado Colorado Springs (50) Denver (43) Littleton (7) employees

5 State of Montana Helena (10) Ft. Peck (47) employees

6 State of Wisconsin Ft. McCoy, near Tomah (10)

7 State of Wyoming Cheyenne (5);

(End of Summary of Changes)