W912L7-15-R-0002_Case_Managment_Solicitation.pdf

SEE ADDENDUM

(No Collect Calls)

W912L7-15-R-0002 21-Apr-2015

b. TELEPHONE NUMBER

615-313-0815

8. OFFER DUE DATE/LOCAL TIME

03:30 PM 26 May 2015

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W912L79. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

JONATHAN FORREN

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

1 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESS

WOMEN-OWNED SMALL

BUSINESS (WOSB)

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

(40) USPFO TN ARNG CONTRACTING

USPFO-TN ARNG PURCHASING & CONTRACTING

PO BOX 41502

NASHVILLE TN 37204-1502

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE 16. ADMINISTERED BY

SEE SCHEDULE

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

615-313-2659FAX:

TEL: 615-313-2653 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

X 8(A)

HUBZONE SMALL

BUSINESS

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL BUSINESS

(EDWOSB)

SIZE STANDARD:

$27,500,000.00

NAICS:

561330

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF84

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

W912L7-15-R-0002

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 Hours Care Coordinators BASE YEAR

FFP

POP 06/12/2015-06/11/2015

FOB: Destination

NET AMT

0002 Hours ONSITE Supervisor

FFP

Period of Performance 06/12/2015-06/11/2015

0003 Hours Case Managers BASE YEAR

FFP

Period of Performance 06/12/2015-06/11/2016

0004 Job Contractor Manpower Reporting BASE YEAR

FFP

Please include fee (IF ANY)to report manpower reporting in regards to PWS section 5.2 Period of Performance 06/12/2015-06/11/2016

0005 Hours OPTION Care Coordinators Option 1

FFP

Period of Performance 06/12/2016-06/11/2017

0006 Hours OPTION ONSITE Supervisor Option 1

FFP

0007 Hours OPTION Case Managers Option 1

FFP

0008 Job OPTION Contractor Manpower Reporting Option 1

FFP

Please include fee (IF ANY) to report manpower reporting in regards to PWS section 5.2 Period of Performance 06/12/2016-06/11/2017

0009 Hours OPTION Care Coordinators Option 2

FFP

Period of Performance 06/12/2017-06/11/2018

0010 Hours OPTION ONSITE Supervisor Option 2

FFP

0011 Hours OPTION Case Managers Option 2

FFP

0012 Job OPTION Contractor Manpower Reporting Option 2

FFP

Please include fee (IF ANY) to report manpower reporting in regards to PWS section 5.2 Period of Performance 06/12/2017-06/11/2018

0013 Hours OPTION Care Coordinators Option 3

FFP

Period of Performance 06/12/2018-06/11/2019

0014 Hours OPTION ONSITE Supervisor Option 3

FFP

0015 Hours OPTION Case Managers Option 3

FFP

0016 Job OPTION Contractor Manpower Reporting Option 3

FFP

Please include fee (IF ANY)to report manpower reporting in regards to PWS section 5.2 Period of Performance 06/12/2018-06/11/2019

0017 Hours OPTION Care Coordinators Option 4

FFP

Period of Performance 06/12/2019-06/11/2020

0018 Hours OPTION ONSITE Supervisor Option 4

FFP

0019 Hours OPTION Case Managers Option 4

FFP

0020 Job OPTION Contractor Manpower Reporting Option 4

FFP

Please include fee (IF ANY) to report manpower reporting in regards to PWS section 5.2 Period of Performance 06/12/2019-06/11/2020

0021 Hours Care Coordinator (Option to extend)

FFP

Per clause 52.217-8, provide pricing to extend up to 6 months after 4th option period expires

0022 Hours ONSITE Supervisor (Option to extend)

FFP

Per clause 52.217-8, provide pricing to extend up to 6 months after 4th option

0023 Hours Case Manager (Option to Extend)

FFP

Per clause 52.217-8, provide pricing to extend up to 6 months after 4th option

0024 Job Contractor Manpower Reporting

FFP

Option to Extend Per clause 52.217-8, provide pricing to extend up to 6 months after 4th option period expires

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (PWS)

FOR

Nonclinical Case Management Services

1. General:

1.1 Scope:

The purpose of this requirement is 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. 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 Tennessee Army National Guard (ARNG) 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 policies and regulations.

1.1.1 TN ARNG Surgeon’s Office requires both case managers and administrative care coordinator support services. The case management position may be filled at a minimum by either a Registered Nurse (RN), Licensed Vocational/Practical Nurse (LVN/LPN) or Social Worker.

1.1.2 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.

1.1.3 Period of Performance (PoP): The period of performance shall be 12JUN15 – 11JUN16, with the possibility of up to 4 option years.

1.2 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 http://www.tricare.mil/ocmo/download/mhs_phi_guide.pdf.

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. 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.

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:

- 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 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.

1.3 Quality Control (QC): The Contractor shall provide a preliminary Quality Control Plan (QCP) with their proposal. The QCP shall include a detailed discussion of the steps proposed to ensure quality, adherence to schedule, proactive communication and adherence to budget. The QCP shall include a description of corrective action steps to take should the Contractor performance be substandard. An organizational depiction of the project team and chain(s)-of-command shall also be included in the QCP. The QCP shall be submitted as part of the proposal.

1.3.1 Quality Assurance (QA): The Government shall develop and utilize a quality assurance plan. This plan shall be primarily focused on what the Government must do to ensure the contractor has performed in accordance with the performance standards.

It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) (defect rate(s)).

1.3.2 Recognized Holidays: The following are recognized US holidays. The contractor is available 365 calendar days a year and is available to perform services on these days:

1.3.3.1 New Year’s Day: January 1st

1.3.3.2 Martin Luther King, Jr.’s Birthday

1.3.3.3 President’s Day

1.3.3.4 Memorial Day

1.3.3.5 Independence Day: July 4th

1.3.3.6 Labor Day

1.3.3.7 Columbus Day

1.3.3.8 Veteran’s Day: November 11th

1.3.3.9 Thanksgiving Day

1.3.3.10 Christmas Day

1.3.4 Place and Performance of Services:

The Contractor shall provide these services in the State of Tennessee collocated with the State Surgeons Office located in Smyrna, TN for work to be performed. 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 as shown below. Specifically, in the event of a mobilization event, the Contractor shall ensure adequate non-clinical case management 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 will notify the COR. If determined to be within the scope of the contract the Contracting Officer will provide 30 calendar day notice to the contractor with full description of the need and request a proposal. The contracting officer 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.

1.3.4.1 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 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.

1.3.4.2 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.

1.3.5 AT Level 1 Awareness Training (AT): Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the Contracting Officer’s Representative (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.

1.3.5.1 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.

1.3.5.2 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.

1.3.5.3 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.

1.3.5.4 CAC Requirements: The Common Access Card (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).

1.3.5.4.i 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 attachment, 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.

1.3.5.4.ii 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 Contracting Officer's Representative (COR) or Contracting Officer. 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.

1.3.5.4.iii 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.

1.3.5.5 AT Level 1 Awareness Training (AT): AT level 1 training, AR715-30, FAR 52.204, FAR52.204 Alt I or Alt II – (within 30 days of contract award)

1.3.5.6 iWatch Training (within 30 days of contract award) The contractor and all associated sub-contractors shall brief all employees on the local iWatch program. 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 with 30 days of contract award and within 15 calendar days of new employees commencing performance with the results reported to the COR NLT 30 calendar after contract award.

http://www.myarmyonesource.com/familyprogramsandservices/iwatchprogram/default.a spx

1.3.5.7 Army Training Certification Tracking System (ATCTS) registration for contractor employees who require 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 informational Assurance Awareness prior to access to the IS and then annually thereafter.

1.3.6 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.

1.3.6.1 Key Control. Case management personnel will obtain and maintain and office door key if required from the facility key custodian. No contract personnel will be authorized an exterior door key the work facility. Once a contractor is no longer employed under the case management contract, all keys must be returned to the key custodian.

1.3.7 Special Qualifications: The non-clinical case nurse manager (RN/LVN/LPN) 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.

1.3.8 The non-clinical direct service social work case managers require the expertise as dictated by the individual State Licensing boards which set the scope of practice for social workers. Case management knowledge domains consist of assessment, planning, implementation, coordination, monitoring and evaluations of the options and services required to meet the ARNG Soldier’s health and human services needs.

1.3.9 The non-clinical case management 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.)

1.3.10 Responsible for tracking medical status of ALL assigned Soldiers.

1.3.11 Responsible for medical charting in eCase.

1.3.12 Request profile exams/evaluations and audiology exams at physical exam center.

1.3.13 Coordinate Soldier treatment plans with appropriate medical facilities.

1.3.14 Maintain automated referrals indicated in MEDCHART.

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

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

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

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

- Considered medically ready.

- Administratively separated from the military.

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

1.3.20 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.

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

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

1.3.23 Obtain release of information from Soldier.

1.3.24 Educate Soldiers on resources available to improve medical and dental readiness.

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

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

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

1.3.28 Stamp all medical documents for verification after uploading.

134.29 Index uploaded medical documents.

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

1.3.31 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.

1.3.32 Contractor will ensure all administrative charting in eCase is completed.

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

1.3.34 Log in eCase any contact with SM (email, voice call, or personal interview).

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

1.3.36 Run MEDPROS report Post PHA/SRP event.

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

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

1.3.39 Ensure Soldiers with T3, T4, P3 or P4 profiles are case managed in the eCase module.

1.3.40 Nurse Case Managers will review medical documentation and prepare Narrative Summary prior to submission to the State Surgeon’s Office for clinical decisions.

1.3.41 Nurse Case managers will facilitate the ongoing planning, implementation and evaluation of Soldiers’ clinical cases in the Medical Management Process.

.1.4 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO. The KO, Contracting Officer’s Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor performance.

1.5 The contactor shall provide a primary point of contact and alternate who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the individual is absent, shall be designated in writing to the COR/KO. The individual or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The individual shall work with the COR, (or the KO if a COR is not assigned), to resolve issues, receive technical instructions, and ensure adequate performance of services.

The individual(s) shall ensure contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The individual(s) shall ensure contractor employees understand services performed outside the scope of the contract are not permitted.

1.6 The contractor shall provide an onsite supervisor at the TNARNG Medical Command location in Smyrna, TN to serve as the lead POC over all contractors who will ensure performance is IAW this PWS. The onsite supervisor must possess at least 3 to 5 years experience in non-clinical case management, supervisory roles, or leadership positions in order to qualify. The onsite supervisor shall possess the expertise to provide oversight in non clinical case management, case management planning, analysis and review, patient risk analysis and service support. Contractor will ensure the onsite supervisor has access to all systems, databases, modules and adheres to the technical requirements of this PWS

1.7 Identification of Contractor Employees: Contractor employees will require badges to be worn at all times in the performance of this contract. All contractor personnel attending meetings, answering Government telephones are required to identify themselves as contract employees to avoid creating an impression they are Government employees. The contractor shall ensure all documents or reports produced by contractor personnel are suitably marked as contractor products or contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities/ Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed. The contractor shall retrieve all identification media (including vehicle passes) from their employees who depart employment for any reason. All identification media (i.e., badges and vehicles passes) shall be returned to the COR/KO within 14 calendar days of an employee’s departure.

1.8 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.

1.9 Contractor Travel: Travel shall be in accordance with the Joint Travel Regulation.

Travel may be required for all Contractor personnel performing on this requirement.

Contractor shall be required to comply with travel policies as outlined in the DoD Financial Management Regulation and the Joint Travel Regulation (JTR).

1.10 Data Rights. N/A

1.11 Organizational 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 statements, 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.

1.12 Transition: Current contract personnel have first right of refusal for continued employment.

2. Definitions and Acronyms:

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 (KO). 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 designated by the KO to monitor contractor performance. 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 the 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 which does not meet the standard of performance associated with the Performance Work Statement.

2.1.5 DELIVERABLE.A deliverable is anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.6 KEY PERSONNEL. Contractor personnel who may be required to be used in the performance of a contract as Key Personnel listed in the PWS.

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

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

2.1.9 QUALITY ASSURANCE. SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10 QUALITY CONTROL. All necessary measures taken by the Contractor to assure the quality of an end product or service meets contract requirements.

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

2.1.12 WORK HOURS. Typical work hours are 8 hours a day, but no more than 40 hours in a work week. No overtime is authorized.

2.1.13 WORK WEEK. Monday through Friday, unless specified otherwise. Case management personnel may be required to work on the weekend during PHAs. Typical work week will be adjusted if weekends are required.

2.2 ACRONYMS:

AFARS Army Federal Acquisition Regulation Supplement AR Army Regulation AT/OPSEC Antiterrorism/Operational Security CFR Code of Federal Regulations CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf DA Department of the Army DD250 Department of Defense Form 250 (Receiving Report) DD254 Department of Defense Contract Security Requirement List DFARS Defense Federal Acquisition Regulation Supplement DOD Department of Defense FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services IA Information Assurance IS Information System(s) KO Contracting Officer

OCI Organizational Conflict of Interest ODC Other Direct Costs PII Personally Identifiable Information 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

3.0 Government Furnished Property, Materials, and Equipment (GFP/M/E):

3.1 Property: The Contractor shall provide support services at the TNARNG Med Command location at Building 250, 8th St, Smyrna, TN 37167. This location can support up to 13 contractors.

3.2 Materials: Office materials such as paper, pens, note pads, staplers, etc, will be provided

3.3 Equipment: The government will provide required computers, scanners, telephones and materials necessary to comply with contract requirements at the job site.

3.4 Services:

3.5 Utilities: Water, electricity, and internet will be provided.

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as required by the contract.

4.2 Secret Facility Clearance: Contract personnel are required to have the NACI.

5.0 Requirements: The intent of this requirement is to provide case management services for the Army National Guard in support of surge and contingency requirements as well as its steady-state mission. Any changes to the initial staffing will be completed through a bilateral supplemental agreement.

5.1 Contractor shall provide at a minimum a License Vocational/Practitioner Nurse (LVN/LPN) (or equivalent as determined by state law requirements), Registered Nurse (RN) or Direct Service Social Worker as Non-clinical Case Managers to provide IMR support to the Army National Guard. Personnel assigned to this requirement shall possess the required technical skills and expertise to perform the functions with minimum guidance. Technical skills for both Nonclinical Case managers and care coordinators include PC proficiency, specifically Microsoft Word and Excel.

5.1.1 The Government will provide training via VTC for eCase to the contract personnel.

HSS assets will conduct for training on MODS and MEDCHART applications.

5.2 Contractor Manpower Reporting Application (CMRA):

5.2.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the National Guard Bureau via a secure data collection site.

5.2.2 The contractor shall completely fill in all required data fields using the following web address: http://www.ecmra.mil/. Reporting inputs shall 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, beginning with 2013. Contractors may direct questions to the help desk at http://www.ecmra.mil

END OF PWS

Historical information of current Case Management for the TNARNG:

We review Medical Documentation for more than 10,200 TNARNG Soldiers. PHAs, profiles, MMPS reviews, SMRB documentation, MEB/ND-PEB documentation, waivers, MAR2s, ADOP (ADME/WTU/RCMC) requests, LOD documentation, INCAP packet documentation, and scan/index medical records for SSMO into HRR

Have approximately 1,000 active cases open. This is an ongoing and reoccurring daily requirement

Review, track, monitor, and create more than 2,200 profiles annually. This is an ongoing and reoccurring daily requirement

Currently have 52 MEBs in process with several packets pending processing.

This is an ongoing and reoccurring daily requirement. Numbers change and increase weekly/monthly.

Case Management Contractors review every LHI Contract PHA (100%) and profile for accuracy. (More than 4,500 PHAs and more than 725 Temp Profiles / 225 Permanent Profiles). This is an ongoing and reoccurring daily requirement.

CM Team participates in every SRP/RSRP.

Prepares all Centcom Waivers for LTC Brown (Deputy State Surgeon) to forward for approval.

Prepares more than 200 SMRB packets annually. This is an ongoing and reoccurring daily requirement

Currently 8 Contractors on staff with incumbent Case Management Contractor

DELIVERABLES SCHEDULE

Deliverables Schedule

WAGE DETERMINATION

WD 05-2497 (Rev.-18) was first posted on www.wdol.gov on 12/30/2014

REGISTER OF WAGE DETERMINATIONS UNDER | U.S. DEPARTMENT OF LABOR

THE SERVICE CONTRACT ACT | EMPLOYMENT STANDARDS ADMINISTRATION

By direction of the Secretary of Labor | WAGE AND HOUR DIVISION

| WASHINGTON D.C. 20210

| Wage Determination No.: 2005-2497

PWS

reference/deliverable title

Frequency Minimal Acceptable Quantity/Quality Measurements

Medium/Format Submit to

Initiate eCase Module Case Management process within 96 hours of event

By event 80% of initiated cases within a 30 calendar day period following event.

MEDCHART

eCASE report

COR

Contact each open/active eCase every 90 calendar days

Monthly No more than 5% delinquency rate

MEDCHART

eCase report

COR

Ecase records shall be reassigned within 5 working days of personnel changeover

All events leading to personnel changeover

100% MEDCHART

eCase report

COR

Follow‐up MODS input from contracted events (PHA/SRP)

After 14 days Within 30 days following contracted event

MODS report COR

Update data input on all UIC Task Force for the State

Weekly No less than monthly

MEDCHART

eCase report

COR

Received medical documentation (scanned into HRR and stamped accordingly) will be transmittal letter to SM’s medical record

Weekly or monthly dependent upon State’s workload

No less than monthly

HRR or

DENCLASS

Records custodian

Diane C. Koplewski Division of | Revision No.: 18 Director Wage Determinations| Date Of Revision: 12/22/2014 Note: Executive Order (EO) 13658 establishes an hourly minimum wage of $10.10 for 2015 that applies to all contracts subject to the Service Contract Act for which the solicitation is issued on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.10 (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract. The EO minimum wage rate will be adjusted annually. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts.

States: Kentucky, Tennessee

Area: Kentucky Counties of Adair, Allen, Barren, Clinton, Cumberland, Metcalfe, Monroe, Russell, Simpson Tennessee Counties of Bedford, Cannon, Cheatham, Clay, Davidson, De Kalb, Dickson, Hickman, Houston, Humphreys, Jackson, Lewis, Macon, Marshall, Maury, Overton, Perry, Putnam, Robertson, Rutherford, Smith, Sumner, Trousdale, Warren, White, Williamson, Wilson **Fringe Benefits Required Follow the Occupational Listing**

OCCUPATION CODE - TITLE FOOTNOTE

RATE

01000 - Administrative Support And Clerical Occupations 01011 - Accounting Clerk I 13.23 01012 - Accounting Clerk II 14.85 01013 - Accounting Clerk III 16.61 01020 - Administrative Assistant 18.54 01040 - Court Reporter 19.75 01051 - Data Entry Operator I 12.35 01052 - Data Entry Operator II 13.48 01060 - Dispatcher, Motor Vehicle 17.02 01070 - Document Preparation Clerk 12.44 01090 - Duplicating Machine Operator 12.44

01111 - General Clerk I 12.54 01112 - General Clerk II 13.38 01113 - General Clerk III 15.02 01120 - Housing Referral Assistant 17.02 01141 - Messenger Courier 12.19 01191 - Order Clerk I 12.72 01192 - Order Clerk II 13.88 01261 - Personnel Assistant (Employment) I 15.11 01262 - Personnel Assistant (Employment) II 16.90 01263 - Personnel Assistant (Employment) III 18.85 01270 - Production Control Clerk 19.21 01280 - Receptionist 12.23 01290 - Rental Clerk 11.44 01300 - Scheduler, Maintenance 13.64 01311 -…