PWS_MED_RECORDS_TECH_Final.pdf

PERFORMANCE WORK STATEMENT (PWS)

MEDICAL RECORDS TECHNICIAN (CARE COORDINATOR)

April 28, 2018

1.0 General:

1.1 Scope: The purpose of this requirement is to provide Medical & 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 meet 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%. District of Columbia Army National Guard (DCARNG) 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 DCARNG Surgeon’s Office requires both case manager 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.

1.2 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 http://www.tricare.mil/ocmo/download/mhs_phi_guide.pdf the MHS. This includes 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 Army National Guard 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 caseloads. 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 Period of Performance (PoP): The period of performance shall be one year from the date of award.

http://www.ncqa.orgorg/ http://www.urac.org/

1.4 General Information: The Contractor shall serve as a Medical Records Technician to the DCARNG to ensure that every soldier is medically ready to execute his/her state and federal mission. The Contractor will work with the Medical Group Health Technician to ensure the proper management of medical records for all assigned to the DCARNG and will ensure other fulltime staff in accomplishing the day to day operations of the Medical Group

1.4.1 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.

1.4.2 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)).

1.4.3 Recognized Holidays: The following are recognized US holidays. The contractor shall not perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King, Jr.’s Birthday

1.4.3.3 President’s Day

1.4.3.4 Memorial Day

1.4.3.5 Independence Day: July 4th

1.4.3.6 Labor Day

1.4.3.7 Columbus Day

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day

1.4.3.10 Christmas Day

1.4.4 Place and Performance of Services:

The Contractor shall provide services between the hours of 0730-1630 Monday through Friday, except on recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Performance shall be at District of Columbia Armory. Located at 2001 East Capital ST Washington, DC 20003. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential. Travel is not authorized for this Contract. 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.

1.4.4.1 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.

1.4.4.2 The contractor’s employees shall become familiar with and obey the regulations of The DC Army National Guard; 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.

1.4.5 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.

1.4.5.1 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.

1.4.5.2 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:

a. Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.

b. Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil).

c. 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.

d. Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.

e. 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.

1.4.5.4 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 https://informationassurance.us.army.mil/

(DEERS) through either an authoritative personnel data feed from the appropriate Service or Agency or Trusted Associate Sponsorship System (TASS).

1.4.5.4.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 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.

1.4.5.4.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.

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 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.

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 which 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:

a.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/).

b.Rejected.* The Government, in separate correspondence, will provide reason(s) for rejection.

c. 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 https://www.dmdc.osd.mil/tass/ http://www.dmdc.osd.mil/rsl/ 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.

1.4.5.5 AT Level 1 Awareness Training (AT): N/A

1.4.5.6 Information Assurance (IA)/Information Technology (IT) Training: N/A

1.4.5.7 Information Awareness: N/A

1.4.5.8 WATCH Training: N/A

1.4.5.9 OPSEC Training: N/A

1.4.5.10 OPSEC SOP/Plan: N/A

1.4.5.11 Classified Information: N/A

1.4.6 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.

1.4.6.1 Key Control. The contractor shall establish and implement methods of ensuring all keys/key cards issued 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 by the Government shall be duplicated. The contractor shall include procedures covering key control in the QC 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 duplicated keys/key cards to the Contracting Officer’s Representative (COR).

1.4.6.1.1 In the event keys, other than master keys, are lost or duplicated the contractor shall, upon direction by 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.

1.4.6.1.2 The contactor shall prohibit the use of the 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 contactor employees engaged in the performance of services in those areas, or personnel authorized entrance by the KO.

1.4.6.2 Lock Combinations. N/A

1.4.7 Special Qualifications: The non-clinical Medical Records Technician requires the expertise as dictated by a minimum skill set determined by the Office of the State Surgeon. The Contractor must have a minimum of 2 years practical experience as in administration with special focus on medical program management. The Contractor will comply with the following Government directives in order to successfully complete the tasks:

a. Service shall be performed in an office environment. This office is located within a medical clinic, and therefore a small potential for exposure to blood borne pathogens exists. The contractor will obtain appropriate blood borne pathogen training in accordance with OSHA 1910.1030 within 12 months of award. Privacy Act of 1974, and must be familiar with the proper management of this type of information.

b. Health Information Portability and Accountability Act (HIPAA), and must be familiar with the proper management of this type of information.

- “For Official Use Only” (FOUO).

- Operational Security (OPSEC) principles and the proper management of

Privacy Act, HIPAA and FOUO information.

c. Suggested Skill Set: In order to successfully meet the performance objectives of this task order, the Contractor employee should possess the following knowledge/skills:

-Strong organizational skills -Strong communication skills, both written and verbal -Basic knowledge of standard office procedures and the ability to interpret general direction

d. The Contractor will have the knowledge and experience needed to use Microsoft Office Suite including but not limited to Excel, Word, PowerPoint, Outlook and be able to use various software programs to maintain database files and prepare reports.

The non-clinical Medical Records Technician to the DCARNG knowledge domains consist of implementation, scheduling, coordination, monitoring of the services required to meet the DCARNG Soldier’s health and human service’s needs.

1.4.7.1 Contactor personnel will not perform inherently governmental functions (i.e., representation of government, decision authority, etc.)

1.4.7.2 Responsible for tracking in eCase the medical status of ALL assigned Soldiers to DCARNG.

1.4.7.3 Administrative Assistants will ensure case manager charting notes are placed in into eCase.

1.4.7.4 Request AVS voucher exams in MEDCHART. To include dental, vision, and audiology exams.

1.4.7.5 Aid Soldiers with treatment plans coordinating with appropriate medical facilities.

1.4.7.6 Monitor automated referrals indicated in MEDCHART, eProfile, eCase, MRR, DENCLASS, and AVS.

1.4.7.7 Aid case manager quarterly at case management meetings with the Medical Detachment leadership to review cases, profile concerns and extensions.

1.4.7.8 Attend PHA events as determined by the needs of the state and the individual Units.

1.4.7.9 Serves as an aid to the case manager with Soldiers referred by a provider for various medical needs.

1.4.7.10 Work with the case manager with Soldiers care from the identification of the condition to when the Soldier is either:

-Considered medically ready.

-Administratively separated from the military.

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

1.4.7.12 Ensure all medical documentation received from the Soldier and/or their medical facility is received and placed in appropriated electronic record, as well as the Soldier’s Service Treatment Record. Conduct review of all documents in HRR for Soldiers who have an open case.

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

1.4.7.14 Work with the case manager in providing the records custodian and/or delegate with all relevant medical/dental documentation.

1.4.7.15 Obtain release of information from Soldiers.

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

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

1.4.7.18 Review and tracking of health assessment (PHA, SRP) etc.

1.4.7.19 Scan medical documents of case managed Soldiers into Health Readiness Record (HRR).

1.4.7.20 Stamp all medical documents with the HRR stamp for verification after uploading into HRR.

1.4.7.21 Index all uploaded medical documents in HRR.

1.4.7.22 Ensure submission of documentation into MODS for immunizations, designation of pregnancy, eye exams, and medical warning tags.

1.4.7.23 Provide all medical documents received for case management to records custodian and/or delegate to be filed.

1.4.7.24 Ensure all administrative charting in eCase is completed.

1.4.7.25 Track all medical appointments or communication with Soldier and unit in eCase.

1.4.7.26 Contact Soldier at a minimum every 30 days and log in eCase. Track Soldiers adherence to medical appointment by contacting Soldier’s leadership staff and conversing with Soldier.

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

1.4.7.28 Run MEDPROS report pre and post PHA/SRP event.

1.4.7.29 Work with the case manager in monitoring MEDPROS to ensure all scheduled services are completed/updated and current medical status is reflected.

1.4.7.30 Work with the case manager in reporting Medical Readiness to the Commander or his/her designated representative.

1.4.7.31 Work with the case manager to ensure Soldiers with T3, T4, P3 or P4 profiles are case managed in the eCase module.

1.4.7.32 Contractor will maintain business casual dress standard during all work assignments.

1.4.7.33 Comply with the following Government directives in order to successfully complete the tasks: AR 40-66, Health Insurance Portability Act (HIPAA), Privacy Act of 1974, For Official Use Only (FOUO), Operational Security (OPSEC).

1.4.8 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. Contractor shall meet with COR on a monthly basis to discuss new hires, training, personnel losses, and plans for replacement of such losses. In addition, the contractor shall meet with the COR biannually for review of licensure of case managers in order to confirm requirements of contract are being met. Purpose of this meeting is to ensure the contract is going well and neither party is preventing successful completion of the contract as required.

1.4.9 Contract Manager (CM): 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.

1.4.10 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.

1.4.11 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.

1.4.12 Contractor Travel: The contractor shall 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 COR recommendation for approval and authorization by the KO prior to travel arrangements being made.

1.4.13 Data Rights. N/A

1.4.14 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.

1.4.15 Phase In / Phase Out Periods: N/A

1.4.16 Telework: N/A

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. The number of hours per day the Contractor provides services in accordance with the contract. The Contractor shall comply with Title 40.1 of the Code of the District of Columbia and the United States Department of Labor Wage and Hour Division concerning any overtime issues. The Contractor shall comply with a 40 hour work week not to exceed 80 hours in a 2 week pay period.

2.1.13 WORK WEEK. Monday through Friday.

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): The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1 Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include desk space, telephones, computers and other items necessary to maintain an office environment

3.2 Materials: N/A

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: N/A

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: Contracted employees will meet all requirements of a NACI clearance. Contractor shall not require a security clearance for contracted employees.

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 contractor.

Contact Clinical Operations Branch, Chief Surgeon’s Office 30 days prior to anticipated award to schedule training.

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 DCARNG 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

6.0 Applicable Publications: Publications applicable to this PWS are listed below: N/A

TECHNICAL EXHIBIT 1

Performance Requirements Summary This Performance Requirements Summary includes performance standards. The Government will use these standards to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

PWS

Paragraph

Required Service

Performance Standards

Acceptable Quality Levels

Method of Surveillance

1.4.7.2 Tracking of cases Ensure that a case has

been initiated and progress tracked for Soldiers referred by a provider for a medical issue.

95% accuracy and completeness with first draft.

100% accuracy with one correction/rewrite

100% inspection performed by Case Manager

1.4.7.5 Treatment plans Aid Soldiers with

treatment plans coordinating with appropriate medical facilities.

95% accuracy and completeness with first draft.

100% accuracy with one correction/rewrite

100% inspection performed by Case Manager

1.4.7.12 1.4.7.21

Receive Medical Documentation.

Ensure all medical documentation received and placed in appropriated electronic record

95% accuracy and completeness with first draft.

100% accuracy with one correction/rewrite

100% inspection

1.4.7.16 Educate Soldiers Educate Soldiers on

resources available to improve medical and dental readiness.

95% accuracy and completeness with first draft.

100% accuracy with one correction/ rewrite

100% inspection of eCase records

1.4.7.25 1.4.7.30

Scheduling Track all medical appointments or communication with Soldier and unit in eCase.

95% accuracy and completeness with first draft.

100% accuracy with one correction/ rewrite

100% inspection of deliverables

1.4.7.28 Run Reports Run MEDPROS report

pre and post PHA/SRP event.

95% accuracy and completeness with first draft.

100% accuracy with one correction/ rewrite

100% inspection of past treatment plans

TECHNICAL EXHIBIT 2

Deliverables Schedule

(Deliverables must be identified in the PWS and then summarized here. See examples below)

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.5.6 AT Level 1

Awareness

Training Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.10 Identification

Media

Return within 14 days of employee’s departure from contract performance.

Original(s) Hard Copy KO

1.4.5.11 OPSEC

Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.6.1 Key

Control

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

KO