U009--Women's Health Training (VA-21-00036999)

Performance Work Statement

The purpose of this Performance Work Statement (PWS) is to obtain contractor expertise and support to demonstrate a proof of concept in using the WHTT framework as an effective outreach tool to engage both rural and urban, unenrolled women Veterans and positively impact their enrollment and utilization of VA health care. The base year timeline includes, conducting focus groups, modifying the existing WHTT curriculum, developing and implementing a targeted communications strategy, identifying locations with significant numbers of unenrolled women Veterans to target, identifying community partners, followed by training delivery both in-person and virtually with continuous evaluation. The focus groups, WHTT modification, identification of sites and planning partners as well as communication strategy will be completed in first 6 months of the contract. Due to COVID-19, training will be delivered virtually from August through September 2021. If feasible, in-person sessions will commence for remainder of the contract base period for a total of 35 virtual plus in-person training sessions. These dates assume a contract start date of February 1, 2021.

The following 8 sub-initiatives comprise the framework needed to accomplish goals in the base year of this project:

Kick off meeting with contractors and key VA staff Conduct Focus Groups with representatives of target population Modify current WHTT curriculum to ensure relevancy for target population. The curriculum will include a, handbook, instructor guide and slide deck One update of the curriculum using participant feedback from ongoing sessions and/or policy updates from VA Women s Health Services Implementation of modified VA s WHTT (including both in-person and virtual versions of the curriculum) Identify locations to hold trainings Identify community partners to assist with outreach and participant recruitment Develop platform for online registration of virtual training Develop and implement communications and outreach strategy to enroll participants in training Development of training session schedule Collaboration and coordination with training site POCs and VA Women Veteran Program Managers and other VA personnel, if applicable, for scheduling, outreach, advertisement of training sessions. Preparation of training materials including handbooks, data collection materials, feedback forms and pre- and post-questionnaires from provided curriculum Arrangement of all travel for contractor personnel involved in training sessions, as well as tracking and reporting per diem and travel expenses associated with each in person session Delivery of no less than a combination of 35 in-person trainings virtual trainings to target population Train instructors and instructor assistants to accurately and effectively deliver training Program evaluation - Data collection, analysis - Qualitative interviews with former participants - Ongoing Data Reporting - Report Writing Distribute Ongoing Participant Communications Develop Presentations/ Final Report to Internal Client Stakeholders

3. Period of Performance

The estimated Period of Performance (POP) is 3 years, with one-year base period, and 2 one-year option periods. During each of the option year periods, contractor will continue to identify geographic locations to deliver trainings, identify community partners, deliver trainings, and evaluate effectiveness of program. The base period is estimated to begin from date of award through 12 months. A kick-off meeting will be held no later than 14 days post contract award date.

Base Year: Date of Award 12 months from date of award.

Any work at the Government site shall not take place on Federal holidays or weekends unless directed by the Contracting Officer (CO). There are ten (10) Federal holidays set by law (USC Title 5 Section 6103) that VA follows:

Under current definitions, four are set by date:

New Year's Day January 1 Independence Day July 4 Veterans Day November 11 Christmas Day December 25

If any of the above falls on a Saturday, then Friday shall be observed as a holiday. Similarly, if one falls on a Sunday, then Monday shall be observed as a holiday. The other six are set by a day of the week and month:

Martin Luther King's Birthday Third Monday in January Washington's Birthday Third Monday in February Memorial Day Last Monday in May Labor Day First Monday in September Columbus Day Second Monday in October Thanksgiving Fourth Thursday in November

3.2. Training Changes or Cancellations. The Government will generally only cancel workshops due to: Severe emergencies, weather conditions, or critical national events such as pandemics that are unforeseen and unpredictable; and during Federal-wide or agency shut down periods. Workshops may also be cancelled due to local emergencies or an occasional need to change the dates and locations of workshops. The Government will notify the contractor when workshop dates are changed or cancelled due to any of these circumstances. When the contractor is given a minimum of 21 calendar days notice prior to the scheduled class start date the Government may cancel and/or substitute, relocate, or reschedule workshops without penalty and at no additional cost to the Government. When less than 21 calendar days notice is given (e.g., in the event of an emergency or Government shut down), workshops may be substituted, relocated, or rescheduled by mutual agreement of the Government and contractor, within the task order period of performance, at no additional cost to the Government. If the Government does not provide notice within 21 calendar days and the workshop is not rescheduled, the contractor will receive a fee of 20% of the scheduled workshop s cost.

4. Place of Performance

Most of the work will be performed in support of VHA s Office of Women s Health in Central Office, Washington DC, and at other VA or partner locations around the country. The vendor may perform background work in their own offices or virtually if necessary, but majority of meetings and reporting will be conducted in the Washington DC metro area. There may be an occasional requirement to participate in meetings at the VA Strategic Acquisition Center (SAC) in Frederick, MD or the VA Acquisition Academy (VAAA) in Frederick, MD.

5. Travel

Travel will be allowed for 2 contractor employees to conduct focus groups and for each of the in-person training sites for 12 months in the base year. Travel will also be allowed for one evaluation specialist to 10% of sessions in the base year. For purposes of quality control, travel will also be allowed for the project manager to travel to 5% of training locations during the base year. Otherwise travel will not be allowed when virtual means of communication will suffice; whether virtual means suffice will be determined based on CO or COR discretion. Local travel within a 50-mile radius from the contractor s facility is considered the cost of doing business and will not be reimbursed. This includes travel, subsistence, and associated labor charges for travel time. Travel performed for personal convenience and daily travel to and from work at the Contractor s facility will not be reimbursed. Good faith estimates should be used to quote the estimated travel and rental auto costs.  Per Diem rates must not exceed GSA s mileage reimbursement rates or GSA s local per diem rate for specific location of travel and contractor shall not exceed limitation of funds specified in the contract. For each of the two-year option periods, travel will be allowed for 2 contractor employees to each of the in-person training sessions. Travel will also be allowed for one evaluation specialist to 10% of sessions in the base year. For purposes of quality control, travel will also be allowed for the project manager to travel to 5% of training locations during the base year.

6. Specific Tasks and Deliverables

The overarching task and deliverable of this PWS is to modify, deliver and evaluate the effectiveness of VA Women s Health Transition Training to a new target audience.

The contractor is expected to provide a substantial experience with conducting women Veteran focus groups including recruitment of subjects and analyzing results, human centered design, the ADDIE Model, and the VA s Women s Health Transition Training content; including expertise, experience and first-hand knowledge with developing and delivering this type of content to women Veterans. This requirement includes identifying women veterans who actively utilize women s healthcare in VA, who are also relatable to women Veterans in terms of experiences and culture, and who are experienced at presenting complicated information to an audience with varying cultural and socioeconomic backgrounds as instructors of this course. The contractor is also expected to have significant managerial experience with implementation of national programs, as well as have nationwide access to personnel with expertise as described above. In addition, the contractor is expected to have significant experience with developing targeted marketing and advertising campaigns especially to minority women Veterans; and have the ability to leverage significant internal resources to successfully implement this communications plan. In addition, prior experience working with American Indian women Veterans either through the VA Tribal Outreach Worker program or through the Indian Health Service is preferable. Finally, the contractor must demonstrate significant experience and expertise in performing complicated program evaluation and analysis. Success will be delivery of this module to no less than a combination of 35in-person and virtual training sessions in the base period that results in positive feedback from the audience and gains in knowledge about the seven items listed in above paragraph. The following list articulates more specifically the tasks and deliverables believed needed to achieve this goal:

6.1 Project Management:

The project manager will provide authority and control over all technical, business, risk management, and testing. A project work plan that includes details on how the deliverables described below will be accomplished as well as a risk mitigation strategy will be required. The project management plan will be due 60 days after award and updated through the POP. The project management plan will be reviewed with the COR, VA Women s Health Services and Contractor program leadership at a bi-weekly meeting. Normally, these meetings can alternate between virtual and face-to-face (with dial-in capability).

The project manager will be responsible for managing the staffing, timeline, budget and deliverables for this requirement. The project manager will schedule and plan all the logistics for a kickoff meeting to start this project. The purpose of this meeting is for the VA personnel and contract staff to meet in-person (and virtually) to understand project objectives and constraints, discuss proposed approach, tasks, and schedules; as well as introduce team members and stakeholders, and define their roles and responsibilities. The contractors will facilitate the meeting, and document and distribute meeting notes including any action items after the meeting. In addition, the project manager is responsible for planning and executing all subsequent meetings.

Deliverables:

Conduct kick-off meeting Meeting Minutes Bi-Weekly Update Meetings

6.2 Training Design and Delivery

6.2.1 Conduct Focus Groups

The contractor will apply for approval under the General Clearance for the Collection of Routine Customer Feedback from OMB to conduct focus groups and conduct in-depth interviews of WHTT participants (described in 6.4.1 below). The contract team will conduct 5 virtual focus groups of unenrolled women Veterans from various urban areas of the country to ascertain their perceptions of VA and VA health care, difficulties in accessing care, their unmet health care needs as well as identify VA health care services and health topics of interest. These groups should include those women Veterans from underserved, minority populations, These Veterans will be recruited through VSO s, Rally Point, and other social media as well as from VA Women s Call Center Data. All focus groups should reflect diversity in ages and racial/ethnic groups if possible.

Deliverables:

Assemble and submit package to OMB for expedited review and approval for focus groups and in-depth participant interviews (described in 6.4.1 below) of women Veterans Complete 5 focus groups Compiled results of completed focus groups

6.2.2 Modify Existing WHTT Curriculum

The contractor will use the ADDIE instructional design framework and use key findings from these 5 focus groups as well as from 5 focus groups of rural, unenrolled women Veterans conducted by the VA Office of Rural Health to inform modification of the WHTT curriculum. (The ORH team has access to established rural women Veteran networks, that include American Indian women Veterans, from which they can recruit for participation in the focus groups. This activity is not included in the PWS and will not cost the vendor). Not only will the curriculum be modified to achieve new learning objectives but will also be considerably streamlined by removing information not relevant to the new target population. Deliverable:

One modification to the VA women s health transition training curriculum materials including the slide deck, participant workbook, and instructor guide.

6.2.3 Identification of Training Locations

The contractor will identify geographic locations with significant numbers of unenrolled women Veterans in which to hold both virtual and in person training sessions. Using both the VA Office of Rural Health geographic mapping tool and data from the VA Women s Call Center, geographic locations around the country will be targeted for this outreach initiative. An example of the capabilities of the ORH Mapping Tool is shown below:

The circles in each of the counties in Texas represent women Veterans who are not enrolled in VA health care. The larger and darker the circle, the higher the population of these women. For instance, the darkest, largest circles represent a range of 200 to nearly 15,000 women who are not enrolled in VA health care by individual county. The red triangles and plus signs represent VA sites of care.

Deliverable:

Identification of a mix of 35 urban and rural locations that have significant numbers of unenrolled women Veterans and identification of 50 urban and rural locations that have significant numbers of unenrolled women Veterans in option years 1 and 2.

6.2.4 - Identification of Community Partners

Once training locations have been determined, the contractor will identify local community partners to assist with marketing both the virtual and in-person training to women Veterans as well as to physically host in-person training sessions. Potential community partners include personnel from local VA sites of care, Veteran focused non-profits, local Veteran Service Organizations, local Congressional offices, local outreach events, local churches, local media, community leaders, and state and county Veteran services offices. In addition, VA partners such as Walmart will be approached to assist with marketing.

Deliverable:

Identification of community partners at each geographic location selected for training in the base year and option years 1 and 2.

6.2.5 Development of a Targeted Communications Strategy

Outreach and communication strategies as well as effective messaging will be critical to encourage participation in the training. Many effective communication products have already been developed for the WHTT program including flyers, podcasts, videos and social media messaging. The contract team will develop a targeted marketing, outreach and communications strategy using these products and others that may need to be developed, to maximize awareness and participation of rural and urban unenrolled women veterans at targeted locations. This strategy will include a marketing mix to understand how the training opportunity can best leverage VA websites, social media channels, community partners and influencers, as well as local publications to get the word out about the training opportunity. In the case of American Indian women Veterans, we will seek to enlist the support of the VA Office of Rural Health, the VA Office of Tribal Governmental Relations and VA Tribal Outreach Workers.

Deliverables:

Creation and deployment of Marketing, Outreach and Communications Strategy and Timeline for base year and option years 1 and 2. Finalized marketing materials such as Website content development, website page creation, videos, customized messaging database for different audiences, influencer outreach.

6.2.6 Conduct training sessions

The contract team will deliver the modified women s health transition training both virtually and in-person if possible to urban and rural locations around the country with significant numbers of unenrolled women Sessions will be facilitated by the training team, with the assistance of identified subject matter experts (SMEs) from the local VAMC, such as the Women Veterans Program Manager (WVPM) and/or other VA personnel, if possible.

The contract team will deliver no less than a combination of 35 in-person and virtual training sessions over the base year.

All training team members will complete the train the trainer protocol to ensure a quality and consistent learning experience for participants. The training team will consist of a lead trainer and a training assistant. The training session lead trainer, who must be a women Veteran who uses VA health care, will do the majority of the in-person classroom facilitation. In addition to the lead trainer, the training assistant must be available to help co-facilitate the course, answer participant questions, assist with logistics and taking notes, and document feedback. It is not required that the training assistant is a Veteran, but the training assistant must be a woman. The training team will document any answered questions and provide follow-up to the cohort with their answers. They will also distribute and collect all evaluation and measurement materials (e.g., feedback forms, questionnaires, etc.). Both participant and facilitator feedback will be captured to make necessary revisions and improve the training experience for future audiences.

Deliverables:

Completed training sessions both in-person and virtual (a combination of no more than 35 in the base year. For options years 1 and 2, the combination of virtual and in-person trainings will be increased to 50 each year.) Frequently Asked Questions (FAQs) from each training Distribute, collect and analyze participant questionnaires and feedback forms

6.3 Training Delivery Logistics

6.3.1 Online Training Registration Platform

The contractor will develop an online training registration platform. The platform will be hosted on the VA Office of Women s Health Service website.

Deliverable:

A fully functioning online training registration platform.

6.3.2 Virtual Training Platform

The contractor will be responsible for all the logistics necessary to securely deliver training virtually to registered participants.

Deliverable:

A fully functioning online platform to securely deliver training in a live, virtual format that is accessible via personal computer, smartphone or tablet. . Options include Adobe, WebEx, TEAMS or ZOOM. The contract team must provide technical assistance to attendees. The attendees must be able to ask questions via audio and chat function.

6.3.3 Travel

The contract team will be responsible for booking airfare, hotels and ground transportation for each training team to each training in person session. The contract team will be responsible for booking airfare, hotels, and ground transportation for the evaluation personnel at 10% of sites not including NCR. All travel must be in accordance with US Government travel laws and must conform to US Government per diem limits for a particular city.

Deliverable:

4 quarterly training reports in the base year and in option years 1 and 2

6.3.4 Site Logistics

For each training site, the contract team, will work with the site POC to ensure electronic file compatibility and access for electronic training resources. The contract team will ensure that the training room is set up properly prior to arrival. In addition, the site contract team will work with the POC to ensure that all safety precautions associated with COVID are in place and adhered to (i.e., masking, social distancing).

6.3.5 Material Preparation

The contract team will ensure that all materials required for the virtual and in-person training session are available. In addition, the contract team will be responsible for distributing training session handbooks and all data collection materials, including feedback forms and pre and post questionnaires.

6.4 Training Evaluation

6.4.1 Data Collection, Analysis and Reporting

The contract team will collect, analyze and report on all data collected during the training. Performance measures are to be reported quarterly and will establish trends over time. To track performance, the following data collection methods will be used:

Qualitative Interviews The contract team will schedule and conduct voluntary, confidential interviews to collect more detailed and personal feedback from randomly selected training participants. Evaluation staff from the contract team will join the training team on one visit at some of the training locations to observe the training, collect information, and conduct the in-person interviews. The contract team will use previously developed interview protocols. For a random sample of training sessions that cannot be attended in-person, evaluation staff will request for participant follow up over the phone or via email. Individual Training Session Assessments Each session will include pre-/post assessments and feedback forms to determine effectiveness of the course, training staff, and instructional materials delivered. Each month, the contract team will create and submit a report that summarizes the findings from that month s training evaluations. If there are issues or trends that need to be addressed, the contract team will provide recommendations to resolve the issue/make improvements. If the recommendations involve out of scope revisions to the course materials, the contract team will seek approval from VA before proceeding with additional work. The contract team will use the reports to determine if any redesign of the training is required. Stakeholder Data Reporting In addition to the monthly reports and the final training evaluation report, evaluation staff will work closely with communications staff to develop presentations and reports for stakeholders internal and external to VA. The contract team will use data visualization programs for reporting to easily communicate trends, identify risk/quality issues, and provide recommendations for course improvement.

Deliverables:

Monthly Training & Evaluation Reports for base year and option years 1 and 2. Completion of 12 qualitative interviews of training participants for base year and option years 1 and 2. Modification of the curriculum based on feedback from participant qualitative interviews and participant feedback forms for base year and option years 1 and 2. Final evaluation report on effectiveness of the training (both in-person and virtual) in improving participant knowledge and awareness of women s health services available from VA, enrollment rates into VA health care of participants versus baseline, and utilization of VA health care services among participants versus baseline at the end of the base year. Final reports will also be required for both option years 1 and 2.

6.5 Communications 6.5.1 Distribute Ongoing Participant Communications

The contract team will be responsible for formal communications with course participants, including session invitations, pre-session information, FAQ s and other relevant training information that VA can distribute to new, current, and past course attendees.

Deliverable:

Participant communications

6.5.2 Develop Presentations/Reports to Internal and External Stakeholders

The contract team will develop presentations and reports for any internal and external stakeholders. The contract team will work with the VA Office of Women s Health to review and finalize all materials before presenting to internal or external stakeholders. Presentations and reports will be used to communicate evaluation findings, share status updates or provide other training related information.

Deliverable: 2 presentations/reports in the base year and options years 1 and 2

Deliverable Schedule for Base Year

Item Deliverable Quantity for base year Due Date for Base Year Quantity for Option Year 1 Due Date for Option Year 1 Quantity for Option Year 2 Due Date for Option Year 2 1 Conduct post-award kick off meeting 1 14 calendar days after award

2 Meeting minutes 1 21 calendar days after award

3 Draft project management plan 1 30 calendar days after award

4 Bi-weekly update meetings 25 30 calendar days after award 25 30 calendar days after start of option year 1 25 30 calendar days after start of option year 2 5 Final project management plan 1 45 calendar days after award

6 Identification of a mix ofurban and rural locations that have significant numbers of unenrolled women Veterans.

1

60 calendar days after award 1 30 calendar days after start of option year 1 1 30 calendar days after start of option year 2 7 Complete focus groups 5

60 calendar days after award

8 Compiled results of completed focus groups

1 75 calendar days after award

9

Identification of community partners at each geographic location selected for training.

Ongoing

Ongoing

Ongoing 10 Creation and deployment of Marketing, Outreach and Communications Strategy and Timeline

1 120 calendar days after award 1 60 calendar days after start of option year 1 1 60 calendar days after start of option year 2 11 Finalized marketing materials

1 120 calendar days after award

12

A fully functioning online training registration platform

1 120 calendar days after award

13 A fully functioning online platform to securely deliver training virtually

1 150 calendar days after award

14 One modification to the VA women s health transition training curriculum materials including the slide deck, participant workbook, and instructor guide

1 150 calendar days after award

15 Analysis of participant questionnaires and feedback forms from each training session

35 7 calendar days after each training session 50 7 calendar days after each training session 50 7 calendar days after each training session 16 Compile and submit FAQs from each session 35 7 calendar days after each training session 50 7 calendar days after each training session 50 7 calendar days after each training session 17 Monthly training and evaluation session reports 7 7 calendar days after end of each month with training sessions 9 7 calendar days after end of each month with training sessions 9 7 calendar days after end of each month with training sessions 18 Quarterly travel reports 4 7 calendar days after end of each quarter 4 7 calendar days after end of each quarter 4 7 calendar days after end of each quarter 19 Participant communications

Ongoing

Ongoing

Ongoing 20 Complete in-person and virtual training sessions in base year 35 320 calendar days after award 50 320 calendar days after award 50 320 calendar days after award 21 Complete qualitative interviews with training participants 12 300 calendar days after award 12 300 calendar days after award 12 300 calendar days after award 22 Modification of the curriculum based upon participant qualitative interviews and participant feedback forms 1 340 calendar days after award 1 340 calendar days after award 1 340 calendar days after award 23 Final evaluation report 1 340 calendar days after award 1 340 calendar days after award

340 calendar days after award 24 Stakeholder slide decks 2 As needed 2 As needed 2 As needed

8. Government-Furnished Equipment/Materials/Facilities/Information The Government will provide adequate physical workspace (conference rooms) for scheduled work meetings with contractors, VA women s health personnel as well as subject matter experts and will provide use of conference call platforms. Government information could include finance, policy, systems, human resources, or other reports deemed necessary, with the discretion of the CO. The use of contractor equipment in Government facilities must be approved by Program Office.

9. Personnel

The Contractor shall identify a Program Manager (PM) and an Alternate Program Manager (APM) as Contractor Key Personnel with full authority to represent and act for the Contractor on all contract matters relating to daily operations in accordance with this contract. The PM and ACPM shall serve as primary points-of-contact, providing direct advice to the P&LO Program Manager, the P&LO senior leadership, and the COR on contractual, programmatic and technical matters.

To ensure accomplishment of work, skilled experienced professional and technical personnel practiced in program and transition management are essential for contractor success. These individuals are crucial to the successful performance, the programs being supported, and are identified as key personnel in accordance with solicitation requirements. Key personnel are as follows: Master Trainer, Senior Trainer Program Manager, Evaluation Lead, Marketing Strategy and Communications Lead. The Contractor agrees that the key personnel shall not be removed, diverted, or replaced from work without prior notification to the CO.

Instructional Designer Responsible for modifications to and validation of WHTT curriculum based on results from 10 focus groups and SMEs.

Key Personnel - Master Trainer - Responsible for train the trainer protocol development as well as the training of all workshop instructors; ensures quality and accuracy of training materials and training sessions across the enterprise.

Senior Trainer (Lead Trainer) Responsible for individual workshop sessions. Must master workshop content and conduct live sessions at individual training sites for service women participants transitioning from the military.

Support Trainer (Training Assistant) Assists the master trainer to ensure smooth delivery of course and associated activities. This individual provides live session support and assists Evaluation team with collecting assessment data and conducting focus groups. This individual also supports creating updates to curriculum content. Key Personnel - Program Manager This individual will serve as the main liaison to the VHA Women s Health Services Program Office. They are responsible for SME working group coordination, overall program management, and all deliverables and meeting coordination. They will oversee the work of the program coordinator, evaluation, communications and marketing, and training teams. Program Coordinator . Responsible for program and event coordination for all training. This individual is the main POC for all training sites. Responsible for all training logistics, to include travel arrangements, schedule changes, virtual platform, participant registration, identification of training locations, coordination with community partners and Women Veteran Program Managers, internet access, and location changes. Will support Program Manager to prepare for client meetings and monthly reports and manage follow up. Will support development of executive briefs and presentations for internal and external stakeholders.

Key Personnel - Evaluation Lead - Responsible for the design and implementation of the evaluation protocol. Responsible for updating data collection instruments, training staff on data collection methods, quality assurance of training, and communicating data findings to stakeholders. These individual conducts qualitative and quantitative evaluation, focus groups, survey design and application, and report writing.

Key Personnel - Marketing Strategy and Communications Lead - Responsible for driving strategy, overseeing implementation and timeline, engaging with stakeholders, conducting outreach, managing communications team and deliverables. Executing data collection and analysis for strategy development, overseeing quality of marketing collateral.

Key Personnel - Marketing and Communication Support Specialist - Responsible for designing all marketing and communications material. Building presentation decks for stakeholders, providing logistical support. Responsible for the design and direction of audio and visual tools to be used in training and other training-affiliated marketing products. This individual will also oversee video production and editing. 9.1 Substitution of Personnel:

Any personnel the contractor offers as substitutes shall have the ability and qualifications, including education and experience, equal to or better than the key personnel whose biography was submitted with the successful proposal. Requests to substitute personnel shall be provided to the CO for review and approval. All notification of substitutions in key personnel shall be submitted to the CO at least 15 calendar days prior to making and change in key personnel, to the maximum extent practicable. The notification shall be in writing and shall provide a detailed explanation of the circumstances necessitating the proposed substitution. The contractor shall submit a complete biography/resume for the proposed substitute, and any other information requested by the CO. The CO will evaluate such requests and promptly notify the contractor of approval or disapproval thereof in writing.

10. Quality Assurance Surveillance Plan (QASP)

Performance Standards define required performance for specific tasks. The Government performs surveillance to determine if the contractor exceeds, meets, or does not meet these standards. The Government may utilize a Performance Based Service Assessment Survey, or other methods to compare contractor performance to the Acceptable Performance Levels (APLs).

10.1 Methods of Surveillance:

Various methods exist to monitor performance. The COR shall use any or several of the surveillance methods listed below in the administration of this QASP.

100% Inspection (evaluates all outcomes) - By the 15th of the following month, the COR shall review all of the contractor s performance/generated documentation and document results accordingly. This assessment shall be placed in the COR s QA file.

Random Sample - The COR shall review a random sampling of the contractor s performance/generated documentation and document results accordingly. This assessment shall be placed in the COR s QA file.

Validated Customer Complaint or Validated Below Average APL in a Specific Area - By the 15th of the following month, the COR shall review the contractor s performance/generated documentation corresponding to a validated customer complaint or validated inability to perform in accordance with the APL in a specific area and document your results accordingly. This assessment shall be placed in the COR s QA file.

10.2 Frequency of Measurement

During performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed, and at a minimum, shall be once per month.

10.3 Acceptable Performance Levels (APLs)

Requirement Performance Standard Surveillance Method Outcome WRITTEN COMMUNICATION Uses correct English grammar, punctuation, and spelling 95% of the time; communicates information in a succinct and organized manner, produces written information that is appropriate for the intended audience. Random Sampling Written communication is consistently error-free and clear and concise so that the message is easily understood by others. CUSTOMER SUPPORT Courteous and professional interactions to receive and fill deliverables and in providing contract status. Customer (VA) support satisfaction, having no more than 5 incidents of dissatisfaction. Customer Feedback and Complaints based on interactions with the contractor Customer problems are resolved within the same business day; no more than 5 incidents spent by Government personnel in providing corrective feedback on unacceptable customer service/professionalism

10.4 Documenting Performance

Acceptable Performance The Government shall document acceptable performance in accordance with the chart above. Any report may become a part of the supporting documentation for any contractual action.

Unacceptable Performance When unacceptable performance occurs, the COR shall inform the CO. This will always be in writing although when circumstances necessitate immediate verbal communication, that communication will be followed in writing. The COR shall document the discussion and place it in the COR file.

When the CO determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR) and submit it to the CO. The CO will send the CDR to the contractor's program manager.

The contractor shall acknowledge receipt of the CDR in writing to the CO within two business days of receipt. The CDR will state how long after receipt the contractor has to take corrective action. The CDR will also specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CO shall review the contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO . 11. Data Rights

The Government has unlimited rights to all documents/material 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 Contracting Officer. 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.

12. Citizenship related Requirements: The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals; While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation of their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all E-Verify requirements consistent with Executive Order 12989 and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001. The Contractor agrees to obtain a similar certification from its subcontractors. 13. Inherent Government Functions: Contractor shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy. 14. Registration with Contractor Performance Assessment Reporting System As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed $150,000and shares those evaluations with other Federal Government contract specialists and procurement officials.  The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing.  To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire.  CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS.  CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS).  FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information. Each Contractor whose contract award is estimated to exceed $150,000 requires a CPARS evaluation.  A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations).   Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete.  For contracts exceeding one year, the contracting officer will evaluate the Contractor s performance annually.  Interim reports will be filed each year until the last year of the contract, when the final report will be completed.  The report shall be assigned in CPARS to the Contractor s designated representative for comment.  The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO. Failure for the Contractor s representative to respond to the evaluation within those sixty (60) days, will result in the Government s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor s representative will be locked out of the evaluation and may no longer send comments.  Conflict of Interest: The Contractor is responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided.  The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services.  The Contractor must also provide relevant facts that show how it s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document. 15. Privacy - Training Required All contractor employees and subcontractor employees shall complete the following before conducting sessions.  These online courses are located at https://www.tms.va.gov/plateau/user/login.jsp. Successfully complete the appropriate VA privacy training and annually complete required privacy training; and Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access. 16. Personnel Security Requirements The C&A requirements do not apply to the Government required detailed in this Performance Work Statement, thus a Security Accreditation Package is not required. If VA sensitive information is generated from this work, it will only be transmitted via encrypted email between VA employees. All contracted personnel who require access to the Department of Veterans Affairs shall be the subject of a Security Screening. All contracted personnel who require access to the Department of Veterans Affairs computer systems shall be the subject of a background investigation (BGI), unless specifically exempted IAW VA Handbook 0710. This requirement is applicable to all subcontractor personnel requiring the same access. In all cases, access (physical and computer) cannot be granted until officially notified by Security Investigations Center (SIC), Little Rock, Arkansas. Access can be granted prior to receiving final adjudication results.

The position sensitivity for each contracted position is determined by the VA utilizing the Position Designation System and Automated Tool (PDAT). Each position will be designated at the high, moderate, or low risk level, depending on the position s potential for adverse impact to the integrity and efficiency of the services (5 CFR 731.106). Risk levels determine what level of investigation is required.

The level of background investigation is commensurate with the required level of access. It may be either a Special Agreement Check (SAC), National Agency Check with Written Inquiries (NACI) (low risk), Moderate Background Investigation (MBI) (moderate risk), or Background Investigation (high risk). Non-citizen contracted personnel appointed to low risk positions will be subject to a National Agency Check with Law Enforcement and Credit Check (NACLC). The Department of Veterans Affairs has determined this contract requires the following level of investigations:

___ SAC X NACI ___ NACLC ___ MBI ___ BI

The Contractor shall bear the expense of the background investigation, regardless of the final adjudication determination. If the investigation is conducted by the Office of Personnel Management (OPM) through the VA, the contractor shall reimburse the VA within 30 days. When notified of an unfavorable determination by the Government, the contractor shall withdraw its employee from contract performance.

Failure to comply with security requirements shall result in termination of the contract for default.

The Department of Veterans Affairs (VA) PIV Program Office has implemented the Personal Identity Verification (PIV) program across the enterprise to more than 200 VA sites. The Contractor PIV Card at a minimum requires contracted personnel to be fingerprinted and have a favorable adjudication completed prior to its issue.

Identification badges shall be worn on the front of outer garments at all times while on duty at the VAMC.

Upon receiving the award and throughout the term of the contract, the contractor and Government will adhere to VA background investigation procedures. The following steps outline the background investigation process in accordance with VA SOP 300-010-01:

STEP ONE: Complete Background Investigation Request Worksheet: Within five business days of receiving the award letter, the contractor shall submit a completed Background Investigation Request Worksheet that lists all contractor employees who will be working on the contract to the Contracting Officer or COR via password protected or encrypted e-mail or fax. Note: due to the personal information contained in the Background Investigation Request Worksheet, the information must be sent in a secure manner. Documents containing social security numbers should not be emailed unless the e-mail is encrypted. Within five business days of receiving the Background Investigation Request Worksheet, the VSC Personnel Security Office will enter a background investigation request into the VA Security Investigation Center (SIC) Contractor Request Database (CRD) for each contractor employee. When the request is entered, an automated initial e-mail is sent to the contractor point of contact listed on the Background Investigation Request Worksheet. The automated e-mail identifies the background investigation level requested and provides a website link with further instructions. If a contractor employee has a background investigation from another federal agency, it may be reciprocated as long as the background investigation meets the appropriate level designated in the current statement of work and has occurred within the last five years with a favorable adjudication and no break in service. Please be aware that any public trust case that is older than two years and does not have a favorable adjudication cannot be reciprocated unless it was a no issue case. VSC Personnel Security Office staff will coordinate with the VA Security and Investigations Center (SIC) staff to verify reciprocity. If the contractor employee receives the automated email from the VA SIC CRD and believes he/she may be eligible for reciprocity, please contact the VA SIC using the contact information in the e-mail. Reciprocity is NOT automatic. If a background investigation can be reciprocated, the VA SIC will send an email notification to the contractor. Note: As contract personnel are added to the contract, the Background Investigation Request Worksheet must be updated and submitted to the VSC Personnel Security Office so that a background investigation can be initiated. The additional contract employee cannot start work until all security requirements listed in this letter are completed.

STEP TWO: Complete Special Agreement Check (SAC) (Fingerprinting): All contractor employees are required to be fingerprinted within 14 calendar days of the award notice, except for those who received an e-mail from the VA SIC confirming reciprocity. Courtesy electronic fingerprints can be obtained at some VA facilities. Contact the Contracting Officer or COR to schedule a fingerprinting appointment at a VA facility as soon as possible. Each contractor employee shall take a copy of the VHA Special Agreement Check (SAC) Memorandum to the fingerprinting appointment and complete it. Completed forms shall be faxed to the VSC Personnel Security Office at (216) 447-8020 the same day the contractor employee is fingerprinted. OPM sends the results of the SAC to the VSC Personnel Security Office within 5 days. The VSC Personnel Security Office reviews the results and makes an adjudication recommendation to the CO within 10 days, who will inform the Contractor POC of the outcome.

STEP THREE: Complete and Submit Background Investigation Documents: Upon receipt of the automated e-mail from the VA SIC CRD (see Step One), each contractor employee who did not receive a reciprocation notice, must complete and submit the required documents to the VA SIC within five business days. The submission address will be provided in the automated e-mail. Do not send completed documents to the VA SIC before being fingerprinted or before receiving the initial automated e-mail THE DOCUMENTS WILL BE RETURNED. The VA SIC reviews the documents within seven business days for completion and accuracy. If the documents do not contain any errors, the VA SIC forwards them to the Office of Personnel Management (OPM) to conduct the background investigation. If the documents contain errors, the VA SIC will return them to the contractor with corrective instructions. The corrections must be made immediately and sent back to the VA SIC. Once the documents are completed correctly and VA SIC forwards them to OPM, an automated e-mail is sent to the contractor point of contact stating that the background investigation has been initiated.

STEP FOUR: Obtain Personal Identity Verification (PIV) Card (Security Badge): In order to be eligible to receive a PIV Card, the contractor employee must have both a favorable SAC completion and an initiated background investigation (or reciprocation). Within five business days of reciprocation or receiving notice of initiated background investigation and favorable SAC adjudication, the contractor employee must complete the VHA Service Center Contractor PIV Sponsorship Form and submit it to the Contracting Officer or COR.

STEP FIVE: Complete Required Training and Sign Contractor Rules of Behavior: All contractor employees shall complete the training indicated in the solicitation, including HIPPA training. The contractor shall provide copies of training certificates for each employee within five business days of reciprocation or receiving notice of initiated background investigation and favorable SAC adjudication contractor and annually thereafter to the Contracting Officer or COR. 17. References Breland JY, Phibbs CS, Hoggatt KJ, Washington DL, Lee J, Haskell S, Uchendu US, Saechao FS, Zephyrin LC, Frayne SM. The obesity epidemic in the Veterans Health Administration: prevalence among key populations of women and men Veterans. J Gen Intern Med. 2017;32(Suppl 1):11 17. doi: 10.1007/s11606-016-3962-1 Bullman T, Hoffmire D, Schneiderman A, Bossarte, R. Time dependent gender differences in suicide risk among Operation Enduring freedom and Operation Freedom Veterans. Ann Epidemiol. 2015 Dec;25:964-5 Combellick JL, Bastian LA, Altemus M, Womack JA, Brandt CA, Smith A, Haskell SG. Severe Maternal Morbidity Among Cohort of Post-9/11 Women Veterans. J Womens Health 2020 Apr 29(4):577-584 Eberhardt MS, Ingram DD, Makuc DM, et al. Urban and Rural Health Chartbook: Health, United States, 2001. Hyattsville, MD: National Center for Health Statistics; 2001 Ely DM, Driscoll AK, Mathews TJ.Infant mortality rates in rural and urban areas in the United States, 2014 [Internet]. Hyattsville (MD): National Center for Health Statistics; 2017 Sep [cited 2019 Sep 27]. (NCHS Data Brief No. 285). Available from: https://www.cdc.gov/nchs/data/databriefs/db285.pdf Haskell SG, Heapy A, Reid MC, Papas RK, Kerns RD. The prevalence and age-related characteristics of pain in a samplel of women veterans receiving primary care. J Womens Health. 2006 Sept; 15 (7):862-9 Haskell SG, Gordon KS, Mattocks K, Doggal M, Erdos J, Justice A, Brandt CA. Gender difference in rates of depression, PTSD, pain obesity, and military sexual trauma among Connecticut War Veterans of Iraq and Afghanistan. 2010, 19(2): 267-271.  Haskell SG, Ning Y, Krebs E, Goulet J, Mattocks K, Kerns R, Brandt C. Prevalence of Painful Musculoskeletal Conditions in Female and Male Veterans in 7 Years After Return From Deployment in Operation Enduring Freedom/Operation Iraqi Freedom. The Clinical Journal of Pain, 2012, 28(2): 163-167. Hoffmire, CA, Kemp JE, and Bossarte, RM. Changes in Suicide Mortality for Veterans and Non-Veterans by Gender and History of VHA Service Use, 2000-2010. Psychiatr Serv. 2015 Mar; 48(3)360-4. 

Kang HK, Bullman TA, Smolenski DJ, Skopp NA, Gahm GA, Reger MA. Suicide risk among 1.3 million Veterans who were on active duty during the Iraq and Afghanistan wars. Annals of Epidemilolgy. 2015, 25: 96-100.

Peek-Asa C, Wallis A, Harland K, Beyer K, Dickey P, Saftlas A. Rural disparity in domestic violence prevalence and access to resources. J Women Health. 2011 Nov;20 (11):1743-9.

VA Office of Mental Health and Suicide Prevention. VA National Suicide Data Report, 2005-2016 Department of Veterans Affairs, Veterans Health Administration, September 2018, p. 9. . 12 June 2019. Veteran Support Services Center (VSSC) 2020 Wagner C, Dichter ME, Mattocks K. Women Veterans Pathways to and Perspectives on Veterans Affairs Health Care. Women s Health Issues. 2015 Nov-Dec; 96: 658-65. Washington DL, Farmer MM, Mor SS, Canning M, Yano EM. Assessment of the Healthcare Needs and Barriers to VA Use Experienced by Women Veterans. Journal of Medical Care, 53: S23-31, April 2015. Whitehead AM, Maher NH, Goldstein K, Bean-Mayberry B, Duvernoy D, Davis M, Safdar B, Saechao G, Lee J, Frayne SM, Haskell SG. Sex Differences in Veterans Cardiovascular Health. J Womens Health. 2019 Oct 28(10):1418-1427