PWS_Med_case_Management_2019_2024b.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

Non-Clinical Medical Case Management Services (CTARNG)

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Non-Clinical Medical Case Management Services, as defined in this PWS.

1.2 Background: The purpose of this requirement is to provide Medical and Dental Non-clinical Case Management and administrative Care Coordinator services in support of Individual Medical Readiness (IMR). This requirement is designed to be flexible, responsive, and meets the ever-evolving needs of the government. DoDI 6025.19 establishes aggressive quarterly and annual metric goals for the separate IMR elements and for the overall IMR category of Fully Medically Ready (FMR) soldiers. The ultimate goals are to produce real-time reports based on complete, accurate data. The minimum goal for overall medical readiness is more than 75% of Service members FMR, with the ideal goal being 100%.

1.3 Period of Performance (PoP): The period of performance shall be: One (1) base year of 12 months. Four (4) option years of 12 months each will be available for the government to exercise approximately 30 days before the end of the PoP.

1.4 General Information:

1.4.1 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.

1.4.2 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).

1.4.3 Recognized Holidays: The following are recognized United States (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: December 25th

1.4.4 Place and Performance of Services: The contractor shall provide services between the hours of 0730-1600, 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. Working Saturday or Sunday is possible under this contract and will depend on the mission requirements. Performance shall be at Camp Niantic, Building 804 located at 38 Smith St., Niantic, Connecticut 06357. 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. Teleworking is not authorized.

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 installation; Contractor employees will be given an in brief upon starting performance that will include 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 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.

1.4.5 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 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. 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. CAC issuance requirements are as follows:

In accordance with Department of Defense Manual (DoDM) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. 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 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 3, 2017, and (d) verification of a claimed identity. 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 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 1, 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 an 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: 2LT Jamie Cabezas, jaime.f.cabezas.mil@mail.mil,860-548-3289.

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 FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at:

https://www.dmdc.osd.mil/tass/. The 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.

https://www.dmdc.osd.mil/tass/

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.

1.4.5.1.3 At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification. Identity source documents must come from the list of acceptable documents included in Form I-9, OMB No. 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 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 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.

1.4.5.1.6 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. This can be done by going to:

http://www.us.army.mil and registering 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 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 Health Information Portability and Accountability Act (HIPAA): The HIPAA Privacy Rule creates national standards to protect individuals’ medical records and other personal health information. All contract employees shall complete HIPPA certification course on a yearly basis. 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.

HIPPA training is available at http://www.health.mil/Training-Center/Joint-Knowledge- Online-JKO (https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf) http://www.us.army.mil/

1.4.5.3 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.

1.4.5.4 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:

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

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

1.4.5.4.3 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.

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

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

1.4.5.5 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.

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

1.4.5.6 AT Level 1 Awareness Training (AT): All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete Level 1 AT 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. Level 1 AT is available at http://jko.jten.mil/courses/atl1/launch.html.

1.4.5.7 Information Assurance (IA)/Information Technology (IT) Training: All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter. 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. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.

1.4.5.8 Information Awareness: All contractor employees with access to a government information system shall be registered in the Army Training Certification Tracking System (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://ia.signal.army.mil/DoDIAA/).

1.4.5.9 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. 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.

1.4.5.10 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 http://cdsetrain.dtic.mil/opsec/.

http://jko.jten.mil/courses/atl1/launch.html https://atc.us.army.mil/iastar/index.php https://ia.signal.army.mil/DoDIAA/ http://cdsetrain.dtic.mil/opsec/

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. The contractor shall include procedures covering key control in the QCP. 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 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 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.

1.4.6.1.2 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.

1.4.7 Special Qualifications: CTARNG Surgeon’s Office requires both case managers and administrative support to assist the case management team in the management of their caseload/workload. The case management services shall be provided by any of the following: Registered Nurse (RN), Licensed Vocational Nurse/Licensed Practitioner Nurse (LVN/ LPN) or Licensed Clinical Social Worker.

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 Subpart 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. The CTARNG will conduct progress meetings once a quarter. The dates will be set by the COR and KO, the dates will be communicated via email to the Contractor. The meetings will be conducted via teleconference. 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: Contractor employees will require badges to be worn at all times in the performance of this contract. The contractor employee badge will be supplied by the Contractor. 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. 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 COR/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: No travel will be authorized; all travel will be at the expense of the contractor.

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 Phase In / Phase Out Periods: N/A

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 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 Representative (COR): An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications.

This individual does NOT have authority to change the terms and conditions of the contract.

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

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

2.1.6 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.

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

2.1.8 Quality Assurance: The government procedures to verify that 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 ensure that the quality of an end product or service shall meet 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.

2.2 Acronyms:

AEI Army Enterprise Infostructure AFARS Army Federal Acquisition Regulation Supplement AR Army Regulation AT/OPSEC Antiterrorism/Operational Security BI Background Investigation CCR Customer Complaint Record CFR Code of Federal Regulations CM Contract Manager CMRA Contractor Manpower Reporting Application CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative DA Department of the Army DD250 Department of Defense Form 250 (Receiving Report) DD254 Department of Defense Contract Security Classification Specification DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense DSS Deputy State Surgeon FAR Federal Acquisition Regulation

GFP/M/E/S Government Furnished Property/Material/Equipment/Services HQDA Headquarters, Department of the Army HRR Health Readiness Record HSPD Homeland Security Presidential Directive HSS Health Systems and Services IA Information Assurance IS Information System(s) KO Contracting Officer MRC Medical Readiness Classification NGB National Guard Bureau OCI Organizational Conflict of Interest ODC Other Direct Costs PHA Periodic Health Assessment 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 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, scanners 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, to include employee badges.

5.0 Requirements: The contractor shall provide case management services for the Connecticut Army National Guard in support of surge and contingency requirements as well as its steady-state mission.

5.1 The Government will provide training via VTC for eCase to the contractor.

5.2 Case Management Services:

5.2.1 Contractor shall track medical status of ALL Soldiers.

5.2.2 Contractor shall follow Soldiers’ cases from receipt of case until Soldier receives deployable status or documentation is sent for a fit-for-duty evaluation, Medical Evaluation Board (MEB), or Physical Evaluation Board (PEB).

5.2.3 Perform initial interviews with Soldiers regarding deployment-limiting conditions within 96 hours of notification. Provide Soldiers with their rights and responsibilities going forward, how the Soldiers’ information is to/can be used, and their privacy rights.

Address Soldier questions or concerns in sharing medical data and establish open dialogue.

5.2.4 Contractor shall input all medical and dental data for each Soldier into the appropriate MODS module NLT 72 hours after receipt.

5.2.5 Contractor shall conduct case reviews on a weekly basis. Document results of the case review in an outpatient report containing Soldiers’ names, medical status, and changes from last status report. Report shall be provided NLT 15:30 each Friday.

5.2.6 All medical case review reports shall be provided to the State Surgeon or their delegates.

5.2.7 Maintain all Soldiers’ medical records in accordance with (IAW) AR 40-66.

5.2.8 Coordinate care received by Tricare and by the Military Medical Support Office (MMSO) to obtain prior authorization during the early Tricare period prior to mobilization.

5.2.9 Coordinate with Soldiers to assess medical and/or dental conditions. Arrange for treatment (within the DoD system) of Soldiers possessing conditions that may result in http://armypubs.army.mil/epubs/pdf/r40_66.pdf non-deployment, including outreach efforts, appointment scheduling, and attendance at in-state Soldier Readiness Processing (SRP).

5.2.10 Conduct follow-up interviews, coordinate treatment plans and all referrals when case is resourced by the Government.

5.2.11 Inform CTARNG providers to conduct follow-up appointments upon Soldiers’ completion of recommended healthcare appointments, and provide them with the documentation and information from those appointments, NLT 96 hours after receipt.

5.2.12 Coordinate Soldiers’ healthcare, including the use of consultants for those Soldiers initially using Military Treatment Facility (MTF), Veterans Affairs (VA), Tricare, and non-network providers.

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

5.3 Administrative Support Services

5.3.1 Correspond with Soldiers and medical/dental offices to obtain information for the Soldier’s case management file. Contact will be made with each open/active eCase at minimum every 90 calendar days.

5.3.2 Contractor shall work with soldiers to resolve scheduling conflicts for required medical or dental care.

5.3.3 Obtain the proper release of information forms from Soldiers and medical/dental offices.

5.3.4 Obtain updates from medical/dental office or hospitals for medical records 5 days prior to SRPs and MRBs.

5.3.5 File, scan, and maintain all medical/dental documents IAW local SOP and AR 40- 66 within 5 days of receipt.

5.3.6 Prepare and file all required reports via MEDPROS for the MRC MACOM monthly meetings

5.3.7 Document team case status meetings and make available to the Deputy State Surgeon (DSS) NLT 48 hours after.

5.3.8 Contractor shall perform database system functions as required to process Soldier data in electronic data systems used by the CTARNG via MEDPROS, MEDChart, eCase, HRR, and AVS.

5.3.9 Scrub electronic data system modules before medical/dental events to provide early identification of non-deployable Soldiers.

5.3.10 Review the outgoing correspondence for format accuracy and content IAW AR 25-50 and DA Memorandum 25-52.

5.3.11 Provide administrative support at medical portions of PHA and SRP events and follow-up with MODS input.

5.3.12 Contractor shall follow the regulations and policies that apply to Individual Medical Readiness (IMR) and deployment to include but not limited to: DA PAM 600-8- 101, current year Personnel Policy Guidance Ch. 7, US Centcom Individual Protection and Individual Unit Deployment Policy- Mod. 12, and AR 40-501.

5.4 Additional Services:

5.4.1 Contractor shall complete medical and administrative charting in eCase NLT 48 hours after contact with Soldier, medical professional, or unit.

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

5.4.3 Coordinate Soldier treatment plans with appropriate medical facilities.

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

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

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

5.4.7 Become familiar with the regulations and policies applicable to Individual Medical Readiness (IMR) and deployment, to include the AR 40-501 and other applicable guidance.

5.4.8 Ensure all medical documentation received from the Soldier and/or their medical team is received and placed in appropriate electronic record, as well as the Soldier’s hard copy record, NLT 5 days after receipt.

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

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

5.4.11 Stamp all medical documents for verification after uploading.

5.4.12 Index uploaded medical documents.

5.4.13 Provide Records Custodian or delegate with all relevant medical/dental documentation received by units or Soldier.

5.4.14 Enter immunizations, designation of pregnancy, eye exams, and medical warning tags into MODS.

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

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

5.4.17 Log into eCase any contact with SM (email, voice call, or personal interview) NLT 48 hours after contact.

5.4.18 Communicate with delegated government personnel to track compliance versus noncompliance with maintaining medical readiness.

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

5.4.20 Report Medical Readiness of Soldier to the Commander (or his/her designated representative) during monthly MRC MACOM meeting and as requested in order to provide current case statuses.

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

5.4.22 ECase records shall be reassigned within 5 working days of contractor personnel changeover.

5.5 Contractor Manpower Reporting Application (CMRA):

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

5.5.2 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 http://www.ecmra.mil/ 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 2019. 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:

Publication (Chapter/Page)

Date of Publication

Mandatory or

Advisory

Website

Federal Acquisition Regulation https://www.acquisition.gov/?q=browsefar or http://farsite.hill.af.mil/

Defense Federal Acquisition Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/current /index.html or http://farsite.hill.af.mil/

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

01/23/2014 http://www.esd.whs.mil/Directives/issuances/dod m/

Federal Information Processing Standards (FIPS) Publication 201-2 Personal Identity Verification (PIV) of Federal Employees and Contractors

(paragraph 9)

August 2013 http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.2 01-2.pdf

DoDM 5200.2 Regulation 5200.02 Procedures for the DoD Personnel

Security Program (PSP)

04/03/2017 http://www.dtic.mil/whs/directives/corres/pub1.ht ml

Army Directive 2014-05 Policy and Implementation

Procedures for Common Access Card Credentialing and Installation Access for Uncleared Contractors

03/07/2014 http://www.apd.army.mil/ProductMaps/PubForm/ ArmyDir.aspx

AR 190-13

The Army Physical Security Program

02/25/2011 http://www.apd.army.mil/ProductMaps/PubForm/ AR.aspx

Homeland Security Presidential Directive (HSPD)-12

Policy for a Common Identification Standard for Federal Employees and

Contractors

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

DoDD 5400.11 Department of Defense Privacy

Program

10/29/2014 http://www.dtic.mil/whs/directives/corres/dir.html#

DoD 5400.11-R Department of Defense Privacy

Program

05/14/2007 http://www.dtic.mil/whs/directives/corres/pub1.ht ml

DoDD 8140.01 Cyberspace Workforce Management

08/11/2015 OK http://www.dtic.mil/whs/directives/corres/dir.html

DoD 8570.01-M Information Assurance Workforce

Improvement Program

12/19/2005 (Change 4:

11/10/2015)

OK http://www.dtic.mil/whs/directives/corres/pub1.ht ml

AR 25-2

Information Assurance

10/24/2007 OK http://armypubs.army.mil/ProductMaps/PubForm/ AR.aspx

AR 530-1

Operations Security

09/26/2014 OK http://armypubs.army.mil/ProductMaps/PubForm/ AR.aspx http://www.ecmra.mil/ https://www.acquisition.gov/?q=browsefar http://farsite.hill.af.mil/ http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html http://farsite.hill.af.mil/ http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf http://www.dtic.mil/whs/directives/corres/pub1.html http://www.dtic.mil/whs/directives/corres/pub1.html http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx http://www.apd.army.mil/ProductMaps/PubForm/AR.aspx http://www.apd.army.mil/ProductMaps/PubForm/AR.aspx https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.dhs.gov/homeland-security-presidential-directive-12 http://www.dtic.mil/whs/directives/corres/dir.html http://www.dtic.mil/whs/directives/corres/pub1.html http://www.dtic.mil/whs/directives/corres/pub1.html http://www.dtic.mil/whs/directives/corres/dir.html http://www.dtic.mil/whs/directives/corres/pub1.html http://www.dtic.mil/whs/directives/corres/pub1.html http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

DoD 5220.22-M National Industrial Security Program

Operating Manual

02/28/2006 (Change 2:

05/18/2016)

OK http://www.dtic.mil/whs/directives/corres/pub1.ht ml

AR 381-12

Threat Awareness and Reporting

Program (TARP) (Section II, ¶ 2-4.b)

06/01/2016 OK http://armypubs.army.mil/ProductMaps/PubForm/ AR.aspx

AR 40-501 Standards of Medical Fitness

06/14/2017 https://armypubs.army.mil/ProductMaps/PubForm /Details.aspx?PUB_ID=1002549

DA PAM 600-8-101 03/06/2018 https://armypubs.army.mil/ProductMaps/PubForm /Details.aspx?PUB_ID=1003612

AR 40-35, Preventive Dentistry and Dental Readiness

07/21/2016 http://www.usapa.army.mil

AR 40-562, Immunizations and Chemoprophylaxis for the Prevention of Infectious Diseases

10/07/2013 http://www.usapa.army.mil

AR 40-66, Medical Record Administration and Health Care

Documentation

06/17/2008 Revised:

1/4/2010 http://www.usapa.army.mil

DoDI 1332.18, Disability Evaluation System (DES)

08/05/2014 http://www.dtic.mil/whs/directives/corres/

DoDI 1332.45, Retention Determination of Non-Deployable

Service Members

07/30/2018 http://www.dtic.mil/whs/directives/corres/

DoDI 6025.13, Medical Quality Assurance (MQA) and Clinical Quality

Management in the Military Health System (MHS)

10/29/2013 http://www.dtic.mil/whs/directives/corres/

DoDI 6025.18, Privacy of Individually Identifiable Health Information in DoD

Health Care Programs

12/02/2009 http://www.dtic.mil/whs/directives/corres/

DoDI 6025.19, Individual Medical Readiness (IMR)

06/09/2014 http://www.dtic.mil/whs/directives/corres/

Applicable Medical & Dental

ALARACTS

https://www.us.army.mil/suite/page/550282

Applicable MILPER Messages https://perscomnd04.army.mil/milpermsgs.nsf http://www.dtic.mil/whs/directives/corres/pub1.html http://www.dtic.mil/whs/directives/corres/pub1.html http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://www.usapa.army.mil/ http://www.usapa.army.mil/ http://www.usapa.army.mil/

6.1 Applicable Forms: Forms applicable to the PWS are listed below:

Form Date Website

DD 1172-2

Application for Identification Card/DEERS Enrollment

Mar 2017 http://www.dtic.mil/whs/directives/forms/index.htm

I-9 Employment Eligibility Verification

11/14/16 https://www.uscis.gov/sites/default/files/files/form/i-9.pdf

DD 441

Department of Defense Security

Agreement

Jan 2017 http://www.dtic.mil/whs/directives/forms/dd/ddforms0001- 0499.htm

DD 250

Material Inspection and Receiving

Report

Aug 2000 http://dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/index.htm https://www.uscis.gov/sites/default/files/files/form/i-9.pdf http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm http://dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm

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 5.2.3

Customer Service and

Confidentiality

Contractor shall inform the Soldier of the process and available resources while ensuring confidentiality and privacy concerns will be met

Receive Customer Complaint Records

(CCRs) from less than 5% of cases

CCRs received/ COR will review to determine validity of complaint

5.3.8 Medical and

Administrative Charting in

MEDPROS,

MEDChart, eCase, HRR, and AVS

The contractor shall process database system functions of

Soldiers in MEDPROS, MEDChart, eCase, HRR, and

AVS

No more than 5 instances of data not being processed in the system during the PoP

100% Inspection / COR monthly review of eCase records

5.4.20

MRC MACOM

Meeting Attendance

The contractor shall attend all MRC MACOM monthly meetings in order to provide status of all cases

Contractor representative will be present at all meetings

100% Inspection / COR or COR designee in attendance

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.1 Quality

Control Plan

30 days from award of contract; Updated as needed for life of contract.

1 Electronic Submission

COR/KO

1.4.5.2 Initial and

Annual HIPPA

Training Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.5.8 Registered

in ATCTS;

Complete initial/annual Information

Assurance (IA) training certificate

Provide within 15 calendar days after employee completes training

1 Electronic Submission

COR

1.4.5.6 AT Level 1

Awareness

Training Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.5.9 iWatch Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.5.10 OPSEC

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…