Behavorial Health PWS_REVISED.docx.pdf

Ver. June 2021

PERFORMANCE WORK STATEMENT (PWS)

FOR

Behavioral Health Services

1.0 General: Behavioral Health Professional Services contract provides manpower to the New Hampshire Army National Guard's (NHARNG) Office of the State Surgeon, the

Medical Detachment, and unit Medical Readiness NCOs to support mental fitness and wellness for operational readiness. This is accomplished by developing and maintaining systems for identifying and resolving Soldiers’ behavioral health concerns and by providing clinical oversight and coordination for the behavioral health components of the psychological, family, social, spiritual, and emotional support programs available to service members and their families. The BHP provides support to the Director of Psychological Health (DPH). Behavioral Health Professional Services assists to meet the standards described in medical readiness guidance and leadership goals in order to achieve 95% deployable strength.

1.1 Scope: The purpose of this requirement is to provide skills that are crucial to identifying Soldiers with behavioral health concerns and assisting in determining the disposition of these Soldiers as defined in this PWS. 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 Individual Medical Readiness (IMR) elements and for the overall IMR category of Fully Medically Ready (FMR) Soldiers. The ultimate goal of the NH Army National Guard's

Office of the State Surgeon is to provide a healthy, resilient, ready and deployable force for federal, state and community missions. The contractor plays a large part in meeting this goal by working case management efforts of the Soldier, their medical file, Soldier appointments follow up, and producing real-time reports based on complete and accurate data. The Contractor shall furnish all labor and services required to provide a wide range of medical and mental health services, as well as other related administrative support services and Soldier Readiness Processing (SRP) support.

1.1.1 Reserved

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. 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.

1.3 The period of performance for this contractor shall be 1 March 2022 to 28 February

2023.

1.4 General Information:

1.4.1 Place and Performance of Services: Standard hours shall be 0800 to 1600 on

Monday through Friday as well as one weekend per month during drill weekends, 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. Note that the contractor shall also be required to maintain availability 24 hrs a day, seven days per week, to ensure on-call availability to respond to emergencies. The primary place of performance shall be at 1 Minuteman Way in Concord, NH 03301; however, the contractor may be required to other facilities throughout the State of New Hampshire at the Government’s direction. 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.

1.4.1.1 Telework: The Government does permit the contractor to telework in support of this requirement. In furtherance of Continuity of Operations Planning (COOP), a telework program may be enacted to ensure that the Government's mission-critical operations stay operational during times of national emergency or incidents of national significance. Telework shall be at no additional cost to the Government. The Contractor’s ability telework is at the sole discretion of the Government and, in all cases, shall be authorized in advance.

1.4.1.2 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.

1.4.1.3 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, and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders of the installation, which may affect performance. The Government reserves the right to direct the removal of an employee from Government property or revoke access to Government systems for misconduct, security reasons, or any overt evidence of communicable disease. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

1.4.2 Recognized Holidays: The following are recognized United States (US) holidays.

The contractor shall not perform services on these days:

1.4.2.1 New Year’s Day: January 1st

1.4.2.2 Martin Luther King, Jr.’s Birthday

1.4.2.3 President’s Day

1.4.2.4 Memorial Day

1.4.2.5 Juneteenth National Independence Day: June 19th

1.4.2.6 Independence Day: July 4th

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.9 Veteran’s Day: November 11th

1.4.2.10 Thanksgiving Day

1.4.2.11 Christmas Day: December 25th

1.4.3 Quality Control (QC): The contractor shall develop and maintain an effective QC

Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical

Exhibit 1, Performance Requirements Summary (PRS). A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after contract award.

After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

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

1.4.5 Installation Access and Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services, or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by

Department of Defense (DoD), Headquarters Department of Army (HQDA) and/or local policy (see PWS 6.0). Should the Force Protection Condition (FPCON) change, the

Government may require changes in contractor security matters or processes.

1.4.5.1 For contractors requiring Common Access Card (CAC): The CAC is the DoD

Federal Personal Identity Verification (PIV) credential. Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated Tier 1 or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) physical access to multiple DoD facilities or multiple nonDoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled Tier 1 investigation at the Office of Personnel Management.

Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID System (RAPIDS) using the DD Form 1172-2 or the Trusted

Associate Sponsorship System (TASS).

1.4.5.1.1 Homeland Security Presidential Directive (HSPD)-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them, and shall process all

CAC card applications. The contractor shall ensure that 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 it to the National Guard Bureau (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 that the investigative service provider has received the request, 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 background investigation (BI) will be initiated. The contractor shall ensure immediate compliance with all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from two to six weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that 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.

1.4.5.1.2 Trusted Associate Sponsorship System (TASS): The contractor shall process

CAC applications through the TASS, the procedures for which are described below.

Although there is no requirement for the contractor to designate a “Corporate Facility Security Officer" (FSO) to serve as its single point of contact for the BI, the TASS application process and other CAC and security-related matters, such designation facilitates these processes. If a Corporate FSO is not established, all contractor employees requiring a CAC will be required to process their own applications. The submission process for CAC applications is as follows:

1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA). The TASS TA for this requirement will be: SFC Christopher DuQuette.

2. 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 contractor’s FSO or contractor employee. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at: https://tass.dmdc.osd.mil/tass/. The contractor’s FSO or contractor employee shall follow up to ensure that the TA is processing the request.

3. The Government will inform the contractor's applicant, via email, of one of the following:

a. Approval.* Upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their

CAC. The contractor proceeds to a RAPIDS station (RAPIDS Site Locator:

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

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

c. Return. Additional information or correction to the application required by the contractor employee.

*The contractor shall maintain records of all approved and rejected applications.

1.4.5.1.3 At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by Social Security Number (SSN) and two forms of identification.

Identity source documents must come from the list of acceptable documents included in

Form I-9, OMB No. 1615-0047, "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 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 will be valid for no longer than three years, or until the individual's contract end date (inclusive of any options), whichever is earlier.

1.4.5.1.4 The contractor shall manage requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The contractor shall provide at least 10 calendar days advance notice to the TA, unless there are extenuating circumstances approved by the COR or KO.

1.4.5.1.5 The contractor shall return issued CACs to the DEERS office upon departure or dismissal of each contractor employee, and shall obtain a receipt for each card and provide it to the TA/COR.

1.4.5.1.5.1 Failure to comply with these requirements may result in withholding of final payment.

1.4.5.1.6 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. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.

1.4.5.2 Reserved

1.4.5.3 Awareness Training (AT) Level 1: All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete AT Level 1 training within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee to the COR within 15 calendar days after completion of training by each employee or subcontractor personnel. AT Level 1 awareness training is available at the following website:

https://jko.jten.mil/courses/atl1/launch.html.

https://jko.jten.mil/courses/atl1/launch.html

1.4.5.4 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program (training standards provided by the requiring activity Antiterrorism Officer (ATO)). This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR within 15 calendar days after completion of training.

1.4.5.5 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to 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 that any time contractor personnel 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.

1.4.5.6 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 Army Enterprise

Infostructure (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:

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

1.4.5.6.2 Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://atc.us.army.mil/iastar/docs/Training_BBP.pdf).

1.4.5.6.3 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.

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

https://atc.us.army.mil/iastar/docs/Training_BBP.pdf

1.4.5.6.5 Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.

1.4.5.7 Army Training Certification Tracking System (ATCTS): All contractor employees with access to a Government information system shall be registered in ATCTS (https://atc.us.army.mil/iastar/index.php) at commencement of services, and shall successfully complete the DoD Information Assurance awareness training prior to access to the IS and then annually thereafter. (https://iatraining.us.army.mil/).

1.4.5.8 Information Assurance (IA) Training. All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter.

1.4.5.9 (IA)/Information Technology (IT) certification. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance or appointment to IA/IT functions. In accordance with DoD 8570.01-M, DFARS 252.239.7001, and AR 25-2, contractor employees supporting or performing IA/IT functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.

1.4.5.10 Protection of Personally Identifiable Information (PII). The contractor shall protect all PII encountered in the performance of services in accordance with Defense

Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (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 whose PII has been compromised.

1.4.5.11 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training. Level 1 OPSEC training is available at https://securityawareness.usalearning.gov/opsec/index.htm.

1.4.5.12 OPSEC SOP/Plan. The contractor shall develop an OPSEC Standard Operating Procedure (SOP)/Plan and provide it to the COR within 90 calendar days of contract award to be reviewed and approved by the responsible Government OPSEC officer, per AR 530-1, Operations Security. This SOP/Plan shall include a process to identify the Government's critical information, why it needs to be protected, where it is located, who is responsible for it, and how to protect it. The contractor shall implement OPSEC measures as required by the Government. In addition, the contractor shall https://atc.us.army.mil/iastar/index.php identify an individual who will be an OPSEC Coordinator. The contractor shall ensure this individual becomes OPSEC Level II certified within 90 days of appointment as

OPSEC coordinator in accordance with AR 530-1. Contractor shall provide a copy of the certification to the COR NLT 15 days after completion.

1.4.5.13 Reserved

1.4.5.14 Threat Awareness and Reporting Program (TARP). Per AR 381-12, Threat Awareness and Reporting Program (TARP), contractor employees with security clearances must receive annual TARP training by a counterintelligence (CI) agent or other trainer as specified in Chapter 2 Threat Awareness and Education, Section II, paragraph 2-4b. The contractor shall identify annual TARP training, personnel trained, and date of training within 15 days of training completion.

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. NOTE: All references to keys include key cards. The contractor shall establish and implement methods of ensuring that no keys/key cards issued by the Government are lost or misplaced or are used by unauthorized persons. No keys issued by the Government shall be duplicated. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas.

1.4.6.1.1 The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the COR.

1.4.6.1.2 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 Government replaces or re-keys the locks, the Government will deduct the total cost of lock replacement or re-keying from the monthly payment due the contractor. In the event a master key is lost or duplicated, the Government will replace all locks and keys for that system, and will deduct the total cost from the monthly payment due the contractor.

1.4.6.1.3 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: The contractor shall establish and implement methods of ensuring that no lock combinations are revealed to unauthorized persons. The contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations.

1.4.7 Special Qualifications: The Government is seeking the services of a fully licensed clinical mental health counselor or social worker (LCSW). The contractor shall ensure all employees possess a valid license issued by the NH Board of Mental

Health Practitioners. The contractor shall also have one (1) years’ experience post-licensing. The contractor shall also possess Master’s degree in social work earned from a school that is fully accredited by the Council on Social Work Education (CSWE);

or a Master’s degree in clinical mental health counseling from a graduate program fully accredited by the Council for Accreditation of Counseling and Related Educational

Programs (CACREP). The contractor must also provide an employee resume. The contractor is responsible for providing the credentialing service document to show that the personnel meets the standards directed by the AR 40-68. Furthermore, the contractor is required to provide proof of Professional Liability Insurance for all Medical Personnel supporting clinical requirements. BHP shall have a minimum of two years of experience providing mental health services in a supervised setting. Including a range of experiences involving adult patients, military couple’s therapy, PTSD and combat stress, depression, anxiety, adjustment disorder, suicide and crisis intervention, and substance abuse is highly preferred. This does not include other education or qualifications for the position in which the contractor employee is performing, dress codes, or other information. (NOTE: The Government does not provide training to contractors. Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified, and otherwise qualified to provide services.)

1.4.8 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR 42.5.

The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will apprise the contractor of how the Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced.

The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO.

The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR, to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that 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.

1.4.10.1 The contractor shall retrieve all identification media (including vehicle passes) from its employees who depart employment for any reason. The contractor shall return all identification media (i.e., badges and vehicles passes) to the KO within 14 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 that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at

FAR 22.17.

1.4.12 Contractor Travel: Travel to other government facilities or other contractor facilities may be required and will be specified in the PWS. All travel requirements (including plans, agenda, itinerary, or dates) shall be handled at contractor level. The estimated additional travel shall be up to 2,000 miles per year with a not-to-exceed dollar threshold of $1500. This must be pre-approved by the government (subject to local policy procedures), and is on a strictly cost reimbursable basis. Costs for travel shall be billed in accordance with the regulatory implementation of Public Law 99-234 and FAR 31.205-46 Travel Costs (subject to local policy & procedures; may reference

FAR). Temporary Duty (TDY) is not authorized for this contract.

The contractor shall travel to National Guard facilities throughout the State of New Hampshire as outlined in Technical Exhibit #3 during the performance of this contract to perform the tasks outlined in paragraph 5 of this PWS.

The contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires COR recommendation for approval and/or authorization by the KO prior to travel arrangements being made.

1.4.13 Data Rights: The Government has unlimited rights to all documents/materials produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

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 that 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. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose 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 Reserved

2.0 Definitions and Acronyms:

2.1 Definitions:

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

2.1.2 Defective Service: A service output that does not meet the standard of performance associated with the PWS.

2.1.3 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

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

2.1.5 Physical Security: Actions that prevent the loss or damage of Government property.

2.1.6 Quality Assurance: The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.7 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.8 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements.

2.1.9 Subcontractor: One that enters into a contract with a prime contractor. The

Government does not have privity of contract with the subcontractor.

2.2 Acronyms:

AEI Army Enterprise Infostructure

AR Army Regulation AT/OPSEC Antiterrorism/Operational Security

BI Background Investigation CM Contract Manager COR Contracting Officer Representative

DA Department of the Army DD254 Department of Defense Contract Security Classification Specification

DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense DSCA Defense Counterintelligence and Security Agency

FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services

HQDA Headquarters, Department of the Army HSPD Homeland Security Presidential Directive IA Information Assurance

IS Information System(s) KO Contracting Officer

NGB National Guard Bureau OCI Organizational Conflict of Interest PII Personally Identifiable Information

PIPO Phase In/Phase Out POC Point of Contact

PRS Performance Requirements Summary PWS Performance Work Statement

QA Quality Assurance QASP Quality Assurance Surveillance Plan

QC Quality Control QCP Quality Control Program

SCR Service Contract Reporting SSN Social Security Number TE Technical Exhibit

USD(I) Under Secretary of Defense for Intelligence

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S):

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: None

3.3 Equipment: None

3.4 Services: None

3.5 Utilities: All utilities in the facility will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.

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 indicated in Paragraph 1.1.

5.0 Requirements: The contractor shall have the ability to conduct Military-focused mental health status evaluations as well as maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines. Accordingly, the contractor shall complete appropriate HIPAA training online for use of medical military systems. The contractor shall also have excellent written, oral communication, and computer skills. The contractor is expected to utilize available systems of care and collaborate with social services agencies (i.e. Easterseals) to integrate resources as well as plan and deliver comprehensive services to clientele. The contractor shall also assist identifying problems and gaps in service between the current behavior health delivery system and devise methods to improve and enhance the system. Finally, the contractor shall expect to have a case load of 30-40 cases annually.

The contractor shall also:

5.1 The contractor shall perform initial/intake assessments for self-referrals. The contractor shall make initial diagnoses, formulate treatment plans, and provide follow-up to Soldiers who access behavioral health services of their own accord. The contractor will evaluate NHARNG personnel in accordance with all applicable military regulations to include AR 40-501.

5.2 The contractor shall also conduct routine mental health assessments with a focus on Soldiers who have recently returned from deployment. The contractor will work with those individuals identified as having mental health issues by making an initial diagnosis, formulating treatment plans, and providing all necessary follow up in accordance with all applicable military regulations to include AR 40-501. In the process, the contractor shall facilitate the processing of Soldiers who are no longer fit for duty through appropriate medical and/or administrative separations

5.3 The contractor shall perform mental health assessments on Soldiers who have been command-directed to seek mental health services. The contractor shall support these individuals by making an initial diagnosis, formulating treatment plans, and providing all necessary follow up in accordance with all applicable military regulations to include AR 40-501.

5.4 The contractor shall advise NHARNG leadership on behavior health issues and trends with the potential to impact mission readiness. In the event of case with high visibility or resource intensive requirements, the Contractor shall communicate these cases to medical readiness within 24 hrs of identification.

5.5 The contractor shall enter clinical documentation and paperwork into the appropriate data system within 72 hours of service being rendered, including but not limited to

AHLTA, MEDCHART, eProfile, MEDPROS, Behavioral Health Data Portal (BHDP), and the DOD Case Management System (CMS). They shall also ensure all medical documentation received from the Soldier and/or their medical/BH providers is placed in an appropriate electronic record, along with the Soldier’s hard copy record. Finally, the contractor will also maintain a reporting system to include database spreadsheets. The

Contractor shall create a report, based on data, and submit to NHARNG by the 5 th of each month.

6.0 Applicable Publications: Publications applicable to this PWS are listed below:

Publication

(Chapter/Page) Date of

Publication Mandatory or

Advisory Website

Federal Acquisition Regulation https://www.acquisition.gov/?q=browsefar

Defense Federal Acquisition Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html or https://www.acquisition.gov/dfars

Joint Travel Regulation (JTR) https://www.defensetravel.dod.mil/site/travelreg.cfm

DoDM 1000.13-M-V1 DoD Identif ication (ID) Cards (Enclosure 2, paragraph 3.b)

01/23/2014 (Change 1:

07/28/2020) http://www.esd.whs.mil/Directives/issuances/dodm

Federal Information Processing Standards

(FIPS) Publication 201-2 Personal Identity Verif ication (PIV) of Federal

Employees and Contractors (paragraph 9)

August 2013 http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf

DoDM 5200.2 Procedures for the DoD

Personnel Security Program (PSP)

04/03/2017 https://www.esd.whs.mil/Directives/issuances/dodm/

DoDI 5200.46

DoD Investigative and Adjudicative Guidance for Issuing the Common Access Card (CAC)

09/09/14

(Change 1:

05/04/2018) https://www.esd.whs.mil/Directives/issuances/dodi/

Homeland Security Presidential Directive

(HSPD)-12

Policy for a Common Identif ication Standard for

Federal Employees and Contractors

08/27/2004 https://www.dhs.gov/homeland-security-presidential-directive-12

DoDI 5400.11 Department of Defense Privacy and Civil

Liberties Programs

01/29/2019 https://www.esd.whs.mil/Directives/issuances/dodi/

DoD 5400.11-R Department of Defense Privacy Program

05/14/2007 https://www.esd.whs.mil/Directives/issuances/dodm/

DoDD 8140.01

Cyberspace Workforce Management

10/05/2020 https://www.esd.whs.mil/Directives/issuances/dodd/

DoD 8570.01-M Information Assurance Workforce Improvement

Program

12/19/2005 (Change 4:

11/10/2015) https://www.esd.whs.mil/Directives/issuances/dodm/

DoD 5220.22-M National Industrial Security Program Operating

Manual (NISPOM)

02/28/2006 (Change 2:

05/18/2016) https://www.esd.whs.mil/Directives/issuances/dodm/

DODI 6025.19 Individual Readiness https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/do di/602519p.pdf

Army Directive 2014-05 Policy and Implementation Procedures for Common Access Card Credentialing and

Installation Access for Uncleared Contractors

03/07/2014 https://armypubs.army.mil/ProductMaps/PubForm/ArmyDir.aspx

AR 25-2

Information Assurance

04/04/2019 http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 40-68 Clinical Quality Management https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/r40_68.pdf

AR 40-501 Standards of Medical Fitness https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/ARN8673_ AR40_501_FINAL_WEB.pdf

AR 530-1

Operations Security

09/26/2014 http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 525-13

Antiterrorism

12/09/2019 http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 381-12

Threat Aw areness and Reporting Program

(TARP)

(Section II, ¶ 2-4.b)

06/01/2016 http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx https://www.acquisition.gov/?q=browsefar http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html https://www.acquisition.gov/dfars http://www.esd.whs.mil/Directives/issuances/dodm http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.esd.whs.mil/Directives/issuances/dodd/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

TECHNICAL EXHIBIT 1

Performance Requirements Summary (PRS)

This PRS includes performance objectives the Government will use to determine contractor performance and will compare contractor performance to the Acceptable

Quality Level (AQL).

Performance Objective

Performance Standard Acceptable Quality Levels (AQL)

Surveillance Method / By Whom

5.1 Make

assessments for self-referrals

Periodic Inspection / COR

5.2 Make post-deployment

assessments

Periodic Inspection / COR

5.3 Make

assessments for command-direct referrals

Periodic Inspection / COR

5.4 Report “high

visibility” cases within 24 hrs

Periodic Inspection / COR

5.5 Data entry Periodic Inspection / COR

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.3 Final QCP Within 10 days of contract

award

1 Electronic Submission

COR

1.4.5.1 Information

Assurance Certificate

Prior to the start of the performance period

1 Electronic Submission

COR

1.4.5.1.5 Receipt for

each CAC card returned to the DEERS office

Within 7 calendar days of returning issued CACs to the DEERS office upon departure or dismissal of each contractor employee

1 Electronic

Submission

COR

1.4.5.3 AT Level 1

Awareness Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.5.11 OPSEC

Training Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic

Submission

COR

1.4.5.12 OPSEC

Level II Certification for OPSEC

Coordinator

Provide NLT 15 days after employees completed certification

1 Electronic Submission

COR

1.4.7 Contractor

Resume

NLT 10 days prior to the start of the performance period

1 Electronic Submission

COR

1.4.7 credentialing documentation

Credentialing Documentation IAW AR 40-

1 Electronic Submission

COR

1.4.10 Identification

Media

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

Original(s) Hard Copy COR

5.5 Contractor

report on data entry

No later than the 5th of each month.

1 Electronic Submission

COR

TECHNICAL EXHIBIT 3

The contractor may be required to travel to the following locations throughout the State of New Hampshire. NOTE: All contractor travel must receive prior Government authorization.

Location/Events Address Annual Visits

State Military Reservation 1 Minuteman Way

Concord, NH 03301

Primary work location

Edward Cross Training Center 722 Riverwood Drive

Pembroke, NH 03275

ALT work location 1

Manchester Readiness Center 1059 Canal Street

Manchester, NH

ALT work location 2

Army Aviation Support Facility 26 Regional Drive

Concord, NH

Brock Street Readiness Center 106 Brock St.

Rochester, NH

Franklin Readiness Center 300 S. Main St

Franklin, NH

Hillsborough Readiness Center 140 West Main St

Hillsborough, NH

Hooksett Field Maintenance Shop 1227 Hooksett Rd

Hooksett, NH

Lebanon Readiness Center 174 Heater Rd

Lebanon, NH

Littleton Readiness Center 350 Meadow St

Littleton, NH

Milford Readiness Center 154 Osgood Rd

Milford, NH

Nashua Readiness Center 154 Daniel Webster Hwy.

Nashua, NH

Pease Air National Guard Base Pease Blvd

Newington, NH

Plymouth Readiness Center 19 Armory Rd

Plymouth, NH

Portsmouth Readiness Center 803 McGee Dr

Portsmouth, NH

Raymond Bisson Readiness Center 70 Rochester Hill Rd

Rochester, NH

Regional Training Site 1079 Parker Mountain Rd.

Center Strafford

Somersworth Readiness Center 15 Blackwater Rd

Somersworth, NH