2.  AMENDMENT/MODIFICATION NO. 3.  EFFECTIVE DATE 4.  REQUISITION/PURCHASE REQ. NO. 5.  PROJECT NO. (If applicable)

05 17-Mar-2016 N0001816RC23003 N/A6.  ISSUED BY CODE N00189 7.  ADMINISTERED BY (If other than Item 6) CODE S2404A

NAVSUP FLC Norfolk, Detachment Philadelphia

700 Robbins Avenue, Bldg. 2B

Philadelphia PA 19111-5083

 

DCMA Manassas

14501 George Carter Way

Chantilly VA 20151

 

SCD: C

   8.  NAME AND ADDRESS OF CONTRACTOR (No., street, county, State, and Zip Code)   9A.  AMENDMENT OF SOLICITATION NO.

UNIVERSAL CONSULTING SERVICES, INC.    3975 Fair Ridge Drive Suite 400S    Fairfax VA 22033   9B.  DATED (SEE ITEM 11)

         10A.  MODIFICATION OF CONTRACT/ORDER NO.

  [X]      N00178-07-D-5288-EX02

    10B.  DATED (SEE ITEM 13)

CAGECODE

1SUM1 FACILITY CODE   29-Mar-2014

11.  THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

[   ]The above numbered solicitation is amended as set forth in Item 14.  The hour and date specified for receipt of Offers  [   ]   is extended, [   ]  is not extended.Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing Items 8 and 15, and returning one (1) copy of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) Byseparate letter or telegram which includes a reference to the solicitation and amendment numbers.  FAILURE OF YOUR ACKNOWLEDGEMENT TO BE RECEIVED AT THEPLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER.  If by virtue of thisamendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitationand this amendment, and is received prior to the opening hour and date specified.12.  ACCOUNTING AND APPROPRIATION DATA (If required)

  

13.  THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

(*) A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:  (Specify authority)  THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. INITEM 10A.

[  ]   [X] B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation

date, etc )SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

[  ] C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:  

[  ] D. OTHER (Specify type of modification and authority)  

E.  IMPORTANT:  Contractor [ X ] is not, [   ] is required to sign this document and return       copies to the issuing office.14.  DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible )

SEE PAGE 2 

15A.  NAME AND TITLE OF SIGNER (Type or print) 16A.  NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

     

15B.  CONTRACTOR/OFFEROR 15C.  DATE SIGNED 16B.  UNITED STATES OF AMERICA 16C. DATE SIGNED           BY 17-Mar-2016 

(Signature of person authorized to sign)   (Signature of Contracting Officer)  NSN 7540-01-152-8070PREVIOUS EDITION UNUSABLE

30-105 STANDARD FORM 30 (Rev. 10-83)Prescribed by GSAFAR (48 CFR) 53.243

 

 

      1. CONTRACT ID CODE PAGE OF PAGES

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT U 1 2

GENERAL INFORMATION

The purpose of this modification is to correct the Contracting Officer Representative information under clauses252.232-7006 Wide Area Workflow Payment Instructions (JUN 2012) and Appointment of Contracting Officer'sRepresentative (FISC DET PHILA) (OCT 1992).

All other terms and conditions remain the same.

A conformed copy of this Task Order is attached to this modification for informational purposes only.

The Line of Accounting information is hereby changed as follows:

The total amount of funds obligated to the task is hereby increased from by

The total value of the order is hereby increased from by

The Period of Performance of the following line items is hereby changed as follows:

CLIN/SLIN From To

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SECTION B SUPPLIES OR SERVICES AND PRICES

CLIN - SUPPLIES OR SERVICES

For FFP Items:

Item PSC Supplies/Services Qty Unit Unit Price Total Price

5000 R799 PROGRAM SUPPORT SERVICES FOR PDHRA IAW PERFORMANCE WORK

STATEMENT FFP BASE PoP: 29 MAR 2014 TO 28 MAR 2015 (Fund

Type - OTHER)

12.0 MO

For ODC Items:

Item PSC Supplies/Services Qty Unit Est. Cost

6000 R799 TRAVEL IN SUPPORT OF CLIN 5000; TO BE PERFORMED IN ACCORDANCE WITH

JTR. NOT TO EXCEED AMOUNT OF BASE PoP: 29 MAR 2014 TO 28 MAR

2015 (Fund Type - OTHER)

For FFP Items:

Item PSC Supplies/Services Qty Unit Unit Price Total Price

8100 R799 PROGRAM SUPPORT SERVICES FOR PDHRA IAW PERFORMANCE WORK

STATEMENT FFP OPTION YEAR I PoP: 29 MAR 2015 TO 31 AUG

2015 (Fund Type - OTHER)

5.0 MO

8102 R799 PROGRAM SUPPORT SERVICE FOR PDHRA IAW PERFORMANCE WORK

STATEMENT FFP OPTION YR I POP: 1 SEP 2015-28 MAR 2016

(O&MN,N)

7.0 MO

8200 R799 PROGRAM SUPPORT SERVICES FOR PDHRA IAW PERFORMANCE WORK

STATEMENT FFP OPTION YR II PoP: 29 MAR 2016 TO 28 MAR

2017 (Fund Type - OTHER)

12.0 MO

For ODC Items:

Item PSC Supplies/Services Qty Unit Est. Cost

9100 R799 TRAVEL IN SUPPORT OF CLIN 8100; TO BE PERFORMED IN ACCORDANCE WITH

JTR. NOT TO EXCEED AMOUNT OF OPTION YR I PoP: 29 MAR 2015 TO

28 MAR 2016 (Fund Type - OTHER)

9200 R799 TRAVEL IN SUPPORT OF CLIN 8200; TO BE PERFORMED IN ACCORDANCE WITH

JTR. NOT TO EXCEED AMOUNT OF OPTION YR II PoP: 29 MAR 2016

TO 28 MAR 2017 (Fund Type - OTHER)

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SECTION C DESCRIPTIONS AND SPECIFICATIONS

PERFORMANCE WORK STATEMENT

 PROGRAM SUPPORT SERVICES FOR POST DEPLOYMENT HEALTH REASSESSMENT (PDHRA)PROGRAM

1.       Purpose/Background: In order to support the force health protection strategy, DoD mandated  a series ofhealth screenings to be conducted at critical milestones in the deployment process.   Post deployment healthconcerns, particularly those involving mental health, are frequently identified several months following return fromoperational deployment.  The Post Deployment Health Re-Assessment (PDHRA) extends the health surveillance to3-6 months after return from deployment.   It is intended to proactively identify health concerns that emerge overtime and to more fully address the health needs and concerns of Service members.  Complete information regardingthe PDHRA program is available at http://www nmcphc med.navy.mil/deployment_health/.  The implementation ofPDHRA includes a requirement for electronic submission of all deployment health data. The Navy Marine CorpsPublic Health Center (NMCPHC), formerly the Navy Environmental Health Center (NEHC), has implemented anelectronic solution and process for the completion and tracking of the PDHRA and other related deployment healthdata.  A variety of platforms (web-based, and access database) each feed a NMCPHC database and interface with thefinal repository at the Armed Forces Health Surveillance Center (AFHSC), formerly the Armed Services SurveillanceActivity (AMSA).  The established platforms support ships, field units, medical facilities, travel teams and acontracted Call Center.  The electronic application is completed by the service member and then reviewed by ahealth care provider either over the phone or in person.

 2.       Objective/Scope: The overall objective of the project management support function required by this contractis to improve the effective implementation of the PDHRA program for active and reserve components of the Navyand Marine Corps by increasing access to services and providing outreach and education on post-deploymentservices.  Key sub-objectives include:

·         Achieve program continuity

·         Provide ongoing program support to the field commanders

·         Coordinate services and reporting with and among the field and medical communities

·         Increase PDHRA program compliance     

·         Compile, analyze, interpret, and report PDHRA program data

·         Monitor the program, measure its effectiveness, and improve its services

·         Provide liaison with other services and organizations to facilitate OSD/HA Program objectives. 

3. Tasks: The Contractor shall provide project management support services for the Post Deployment HealthReassessment (PDHRA) program in support of the Navy Bureau of Medicine and Surgery (BUMED), HeadquartersMarine Corps (HQMC) and satellite offices as outlined herein. Onsite contract project management support servicesare required at Headquarters Marine Corps Heath Services Manpower and Reserve Affairs (HQMC M&RA);Commander, Fleet Forces Command, Norfolk, VA; Marine Expeditionary Forces (MEF I), Camp Pendleton, andTwentynine Palms, California; Marine Expeditionary Forces (MEF II) Camp Lejeune, North Carolina; MarineExpeditionary Forces (MEF III) Okinawa, Japan; and Marine Forces Reserve, New Orleans, Louisiana.

3.1. Specified Tasks: The Contractor shall furnish sufficient personnel to ensure that qualified individuals, asspecified above, to provide services described below. The Contractor shall develop, implement and maintain theproject management functions for PDHRA. Through that project management function, provide overall managementand coordination of the PDHRA program, including the following tasks:

3.1.1. Serve as an advocate for the deployment health programs within Navy Medicine. Serve as a resource foradvice on implementation issues and support the appointed HQ representatives on deployment health relatedworking groups, including FHP&R QA and DHA/DMHA WGs. Coordinate with existing systems and

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management to generate compliance data for monthly briefings to higher authority and support the development ofquarterly compliance reports for DHAs, DMHAs, and related referrals and follow-up care   Provide functionalexpertise and support to USMC HQ, including preparation of briefs and taskers, contributing to development ofpolicy and guidance,  and drafting MARADMINs and responses to audits and other inquiries.

3.1.2. Support Navy Medicine and USMC HQ initiatives (e.g. Manager’s Internal Control Program, referralcompliance) that align with or are impacted by the PDHRA program.

3.1.3. Review, evaluate and compile information regarding service member access to the available methods ofcompleting DHAs (online, access database, Call Center, and Site Visit). Coordinate observations and lessonslearned and recommendations for process or technology improvement with BUMED and NMCPHC via weekly HQconference calls with NMCPHC technologists.  Review and validate monthly DHA summary reports from AFHSC.

3.1.4. Develop a forecast of demand for Call Center and Site Visit evolutions (contracted by OSD/Health Affairs toprovide health screening, evaluation and referral coordination for the Reserve Component only). The field managersupporting Marine Forces Reserve (MFR) and the USMC HQ project manager will provide liaison and assist withobtaining emergency referral services for those Marines requiring immediate intervention as identified during DHAand DMHA screening activities.  Historically, these activities frequently occur on weekends   Provide liaison to thefield commanders to generate compliance for their monthly forecasts for the Call Center and Site Visit contractors.

3.1.5. Provide liaison between the field and NMCPHC regarding the use of electronic tools for accessing andcompleting the PDHRA on a weekly basis (via conference call). Communicate and monitor problems with theservice-member access to electronic tools for both, the Active and Reserve Components .

3.1.6. Promote and facilitate training for Local Administrators” (PDHRA Representatives) and selected MilitaryTreatment Facility (MTF) health care providers to ensure they are capable of utilizing the NMCPHC electronic toolsfor their service members. Establish and maintain Local Administrator monthly reporting requirements for both, theActive and Reserve Component

3.1.7. Utilize the NMCPHC Reporting Tool and other reports as needed (AFHSC, Reserve Headquarters System(RHS) and Operational Data Store Enterprise (ODSE) (USMC) to assess the following data: number of medically-certified PDHRA form completions, the number of medically uncertified PDHRA form completions and the numberof PDHRA requirements. At USMC HQ, work with technical support and programmers  of PDHRA related datasystems to ensure operability.  Monitor and assist with developing business logic for continual improvement ofData Mart, and Commander’s dashboard, as it relates to USMC policy affecting deployment health screenings.

3.1.8. Identify obstacles in technology or process that interfere with PDHRA completions and coordinate effectivemarketing/training approaches to correct them.

3.1.9. Provide Headquarters-level Public Affairs Office (PAO’S) and PDHRA Representatives in the field withpromotion material on a quarterly basis. Promote compliance to program objectives on an ongoing basis.

3.1.10. Serve as a facilitator between BUMED, USMC HQ, and other agencies to reduce duplicity and increaseefficiencies in reporting streams. Existing systems include: NMCPHC Reporting Tool, AFHSC Reports, RHS, andODSE (UMSC). Work within the existing reporting systems to ensure that representatives are providinginformation (and/or account access and training), in order to accomplish effective monthly PDHRA tracking.

3.1.11. RESERVED

3.1.12. Adhere to and comply with all DoD, DoN, BUMED and local instructions and notices, which may be ineffect during the term of the contract. In all cases, the dignity of the patient will be given the highest regard, and theprecepts of an MTF “Bill of Rights for Patients” shall be observed. Comply with Health Insurance Portability andAccountability Act (HIPAA), included below, and applicable Privacy/Security regulations (see below).

3.1.13. Ensure appropriate coordination between Active and Reserve segments of PHDRA program and otheragencies (Health Affairs, LOD, on an ongoing basis). Meet with Health Affairs PDHRA management on a monthlybasis and exchange information with the LOD and VA representatives, as necessary

3.1.14. Establish a mechanism through BUMED Data Quality/“MEPRS” Department for routinely identifyingnumber of referrals and number of completed referrals; utilize existing reporting systems to respond to data calls from

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higher authority. Conduct quality assurance measurements in accordance with applicable directives.

3.1.15 Develop, coordinate and disseminate PDHRA standard operating procedures as necessary to strengthenPDHRA program compliance and implementation.

3.1.16 It is expected that a portion of the workload described in the PWS which is performed at Marine ForcesReserves (New Orleans, LA) will be provided to support the Pre-Deployment Health Assessment (DHA) andDeployment Mental Health Assessment (DMHA).

4         Reporting Requirements.

4.1    Simultaneously with the invoice submittal of each month, the contractor shall provide to the PDHRA ProgramManager a report of all services/activities performed under the contract during the previous month’s performanceperiod.  The report shall include Contractor accomplishments, status of project(s) in process, problems encounteredduring the period, and proposed/recommended solutions to problems encountered.  The report shall include a Planof Action and Milestones (POA&M) for the next month’s services. 

4.2    The Contractor shall provide the PDHRA Program Manager or designee with an annual summary report ofaccomplishments, activities, problems, and resolutions within 30 days prior to the end of each contract period. 

 

5.       Personnel Qualifications 

5.1.     The Contract project managers providing support services under this contract are able to read, write, andspeak English fluently in order to effectively communicate with all personnel for which they will interact with duringperformance of this contract.  Contractor employees shall have the ability to enunciate with sufficient clarity to bereadily understood by line commanders, local administrators, senior officials, and BUMED staff.

5.2.     Contractor employees shall possess sufficient initiative, interpersonal relationship skills and social sensitivitysuch that they can relate constructively to a variety of contacts from diverse backgrounds

5.3.     The Contractor shall provids individuals that meet and maintain the following specific qualificationrequirements:

LaborCategory

Estimated FTENumber*

Education Experience

PDHRAProjectManagers

9 Bachelor’s degree from anaccredited university in fieldsrelated to BusinessManagement/Systems, HumanResources, and Allied HealthAdministration.

A minimum of 5 years of experiencewith demonstrated knowledge inexperience providing projectmanagement as identified in thePWS.

Knowledge of Navy/ Marine CorpsActive/Reserve organizations andmilitary deployment is preferred

       * One FTE is equivalent to 1920 hours annually.

 5.4   Project Management support: (historical FTE provided)

Fleet Forces Command, Norfolk, VA ,  1 FTE

Marine Expeditionary Forces (MEF I), Camp Pendleton, 1 FTE

Marine Expeditionary Forces (MEF I), Twentynine Palms, CA, 1 FTE

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Marine Expeditionary Forces (MEF II), Camp Lejeune, NC 1 FTE

Marine Expeditionary Forces (MEF III), Okinawa, Japan, 1 FTE

Marine Forces Reserve and Marine Corps Individual Reserve Support Activity, New Orleans, LA, 2 FTE

National Capital Region /Marine Corps Health Services Manpower and Reserve Affairs (M&RA, MI DIVISION),Quantico, VA, 2 FTE

 It is essential that continuity of services be maintained to the maximum degree possible; hence, substitution ofContractor employees shall be kept to the absolute minimum necessary to perform the services required.

6.        Hours of Operation.

6.1.  The Contractor should normally provide services Monday through Friday.

6.2.  The Contractor is not required to provide services on the day of observance of the Federal holidays.

 

7.       Travel

7.1.   Long distance travel may be required on an occasional basis, typically for three days or less.

7.2.  Local travel may be required on a weekly or intermittently more frequent basis.

 

8.       Government Furnished Property and Services

8.1.  The Government will provide, without cost, the facilities, equipment, supplies, and services listed below. Government-furnished property shall be for use only in the performance of this contract.  The Government willprovide routine scheduled preventive maintenance of Government-furnished equipment in accordance with BUMEDinstructions.  Upon request by the Contractor, the Government will provide repairs of Government-furnishedequipment in accordance with BUMED instructions.

8.2.  The Government will provide the automated systems (such as but not limited to NMCPHC Reporting Tool,AFHSC Reports, Reserve Headquarters System (RHS), and Operational Data Store Enterprise (USMC)) to be usedto collect data and ensure site representatives have access and/or training in order accomplish monthly PDHRAtracking.  The Government will maintain all system hardware and software.

8.3.  The Government will furnish all forms and publications required for the contract.  The Contractor is required tocomply with various instructions, directives and regulations covering routine administrative, safety and securitymatters in the same manner as other members of the staff. 

8.4.  The Government will provide a laser printer, shredder, and Internet email access capabilities if utilized foradministrative and reporting purposes.

8.5.  The Government will provide consumable supplies for accomplishment of project manager requirements. If theContractor deems that additional equipment or supplies are required to perform the services, the Government willconsider requests for such additional equipment/supplies.  Denials of requests for additional equipment/suppliesand/or delays in acquiring any additional equipment/supplies shall not be cause for Contractor nonperformance orclaims under this contract

 

9.       Miscellaneous Provisions

9.1.  The Government will provide station, local, long distance and Defense Switching Network (DSN) telephoneservices for official use only.  Official use does not include:  administrative communications between Contractoremployees on-site and the corporate headquarters.    Contractors performing under this contract will be issued anidentification badge and vehicle decal during the initial check-in procedure IAW local Command instructions.  The

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identification badge shall be worn during performance of work and anytime the Contract Project Managers are onGovernment premises.  The vehicle decal shall be displayed appropriately according to local instruction.  TheContractor shall ensure that each employee's I.D. badge and base vehicle decal are returned to the Government whenhe/she is no longer providing services under this contract due to termination/expiration of the contract.

9.2.   The Government will provide distribution of mail and will provide outgoing mail services for officialcorrespondence such as notification of patients of appointment for consult.

9.3.  A photocopy machine is available for official use only.

9.4.  Orientation.  During the first two weeks of contract performance, all contract personnel shall undergo up to 80hours of Government provided comprehensive orientation.  This orientation will include but is not limited to: command orientation; vehicle registration; personnel identification documents; PDHRA program specific training;automated systems training; and annual training requirements such as fire safety and sexual harassment.  Orientationmay be waived for incumbent personnel who worked at the facility under a previous contract.

10.    Monitoring and Compliance

10.1.           The Government will monitor success of the project manager support services via submitted reports;Medical Treatment Facility local administrator’s and field commander’s feedback, and ongoing monitoring bygovernment surveillance personnel.

10.2.           Performance Standards and Monitoring

10.2.1.      A Quality Assurance Surveillance Plan (QASP) is provided below which outlines consolidatedperformance requirements derived from the specific tasks in Section 6, expected performance contractor performancestandards, the minimally accepted quality level, and the government’s method of surveillance.

 

11.    HIPAA

11.1.           The Contractor shall follow the provisions of the Health Insurance Portability and Accountability Act(HIPAA) and Privacy of Individually Identifiable (PII) Health Information law. 

11.2.           HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

PRIVACY AND SECURITY OF PROTECTED HEALTH INFORMATION

(a) Definitions.  As used in this clause:

 Individual has the same meaning as the term “individual” in 45 CFR 164.501 and 164.103 and shall include aperson who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160and part 164, subparts A and E.

Protected Health Information has the same meaning as the term “protected health information” in 45 CFR 164.501,limited to the information created or received by The Contractor from or on behalf of The Government.

Required by Law has the same meaning as the term “required by law” in 45 CFR 164.501 and 164.103.

 Secretary means the Secretary of the Department of Health and Human Services or his/her designee

Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160, 162 and part 164,subpart C.

 Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR160.103, 164.501 and 164.304.

(b)  The Contractor agrees to not use or further disclose Protected Health Information other than as permitted orrequired by the Contract or as Required by Law.

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(c) The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected HealthInformation other than as provided for by this Contract.

 (d) The Contractor agrees to use administrative, physical, and technical safeguards that reasonably and appropriatelyprotect the confidentiality, integrity, and availability of the electronic protected health information that it creates,receives, maintains, or transmits in the execution of this Contract.

 (e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor ofa use or disclosure of Protected Health Information by the Contractor in violation of the requirements of thisContract.

(f) The Contractor agrees to report to the Government any security incident involving protected health information ofwhich it becomes aware.

 (g) The Contractor agrees to report to the Government any use or disclosure of the Protected Health Information notprovided for by this Contract.

(h) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected HealthInformation received from, or created or received by the Contractor on behalf of the Government, agrees to the samerestrictions and conditions that apply through this Contract to the Contractor with respect to such information.

(i)  The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronicProtected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

(j) The Contractor agrees to provide access, at the request of the Government, and in the time and manner designatedby the Government to Protected Health Information in a Designated Record Set, to the Government or, as directedby the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The Contractor agrees to make any amendment(s) to Protected Health Information in a Designated Record Setthat the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or anIndividual, and in the time and manner designated by the Government.

(l) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure ofProtected Health Information received from, or created, or received by the Contractor on behalf of, the Government,available to the Government, or at the request of the Government to the Secretary, in a time and manner designatedby the Government or the Secretary, for purposes of the Secretary determining the Government’s compliance withthe Privacy Rule.  

(m) The Contractor agrees to document such disclosures of Protected Health Information and information related tosuch disclosures as would be required for the Government to respond to a request by an Individual for an accountingof disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by theGovernment, information collected in accordance with this Clause of the Contract, to permit the Government torespond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordancewith 45 CFR 164.528.

General Use and Disclosure Provisions

 Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information onbehalf of, or to provide services to, the Government for the following purposes, if such use or disclosure of ProtectedHealth Information would not violate the Privacy Rule, the Security Rule or the Department of Defense HealthInformation Privacy Regulation if done by the Government: [List Purposes].

 

Specific Use and Disclosure Provisions

 (a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for theproper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

 (b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for theproper management and administration of the Contractor, provided that disclosures are required by law, or the

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Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remainconfidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to theperson, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of theinformation has been breached.

(c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provideData Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and Stateauthorities, consistent with 45 CFR 164.502(j)(1). 

Obligations of the Government

Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions

(a) Upon request the Government shall provide the Contractor with the notice of privacy practices that theGovernment produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual touse or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses anddisclosures.

(c) The Government shall notify the Contractor of any restriction to the use or disclosure of Protected HealthInformation that the Government has agreed to in accordance with 45 CFR 164.522.

Permissible Requests by the Government

 The Government shall not request the Contractor to use or disclose Protected Health Information in any mannerthat would not be permissible under the Privacy Rule if done by the Government, except for providing DataAggregation services to the Government and for management and administrative activities of the Contractor asotherwise permitted by this clause.

Termination

(a) Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under anyapplicable default or termination provision of this Contract.

 (b) Effect of Termination.

(1)   If this contract has records management requirements, the records subject to the Clause should be handled inaccordance with the records management requirements.  If this contract does not have records managementrequirements, the records should be handled in accordance with paragraphs (2) and (3) below

(2)   If this contract does not have records management requirements, except as provided in paragraph (3) of thissection, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected HealthInformation received from the Government, or created or received by the Contractor on behalf of the Government.This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents ofthe Contractor. The Contractor shall retain no copies of the Protected Health Information.

(3)   If this contract does not have records management provisions and the Contractor determines that returning ordestroying the Protected Health Information is infeasible, the Contractor shall provide to the Governmentnotification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Governmentand the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extendthe protections of this Contract to such Protected Health Information and limit further uses and disclosures of suchProtected Health Information to those purposes that make the return or destruction infeasible, for so long as theContractor maintains such Protected Health Information.

Miscellaneous

 (a) Regulatory References. A reference in this Clause to a section in the Privacy Rule or Security Rule means thesection as in effect or as amended, and for which compliance is required.

(b) Survival. The respective rights and obligations of Business Associate under the ``Effect of Termination''

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provision of this Clause shall survive the termination of this Contract.

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Governmentto comply with the Privacy Rule or Security Rule.

12.  Contractor Access to Federally Controlled Facilities and/or Unclassified Sensitive Information orUnclassified IT Systems (May 2010)

Homeland Security Presidential Directive (HSPD)-12, requires government agencies to develop and implementFederal security standards for Federal employees and contractors.  The Deputy Secretary of Defense Directive-TypeMemorandum (DTM) 08-006 – “DoD Implementation of Homeland Security Presidential Directive – 12(HSPD-12)” dated November 26, 2008 (or its subsequent DoD instruction) directs implementation of HSPD-12. This clause is in accordance with HSPD-12 and its implementing directives.  This clause applies to contractoremployees requiring physical access to any area of a federally controlled base, facility or activity and/or requiringaccess to a DoD computer/network, to perform certain unclassified both non-sensitive and sensitive duties.  It is theresponsibility of the command/facility where the work is performed to ensure compliance. 

The contractor shall designate an employee to serve as the Contractor’s Security Representative.  Within three workdays after contract award, the contractor shall provide to the Navy Command’s Security Manager and theContracting Officer, in writing, the name, title, address and phone number for the Contractor’s SecurityRepresentative.  The Contractor’s Security Representative shall be the primary point of contact on any securitymatter.  The Contractor’s Security Representative shall not be replaced or removed without prior notice to theContracting Officer.  

This clause applies to contractor, who require IT-II privileged access  to a DoN or  DoD unclassifiedcomputer/network, access to Public Health Information,   provide support associated with fiduciary duties, orperforming duties that have been identified by DON as National Security Positions when are under CNO (N09N2)purview (as advised by the command security manager).  To obtain a favorable determination, for assignment to aNational Security Position each contractor employee must have a favorably completed  National Agency Check withLocal Credit Checks (NACLC) which consists of a NACI including a FBI fingerprint check plus credit and lawenforcement checks.  Each contractor employee is required to complete:

·         SF-86 Questionnaire for National Security Positions (or equivalent OPM investigative product)

·         Two FD-258 Applicant Fingerprint Cards

·         Original Signed Release Statements

Failure to provide the required documentation at least 30 days prior to the individual’s start date shall result indelaying the individual’s start date.  To maintain continuing authorization for an employee to access a DoDunclassified computer/network,  have access to sensitive unclassified information, and/ or Public Health Informationthe contractor shall ensure that the individual employee has a current requisite background investigation.  TheContractor’s Security Representative shall be responsible for initiating reinvestigations as required and ensuring thatbackground investigations remain current (not older than 10 years) throughout the contract performance period.

IT Systems Access

When access to IT systems is required for performance of the contractor employee’s duties, such employees shallin-process with the Navy Command’s Security Manager and Information Assurance Manager upon arrival to theNavy command and shall out-process prior to their departure at the completion of the individual’s performance underthe contract.  Completion and approval of a System Authorization Access Request Navy (SAAR-N) form is requiredfor all individuals accessing Navy Information Technology resources.  The SAAR-N shall be forwarded to the NavyCommand’s Security Manager at least 30 days prior to the individual’s start date.  Failure to provide the requireddocumentation at least 30 days prior to the individual’s start date shall result in delaying the individual’s start date.

When required to maintain access to required IT systems or networks, the contractor shall ensure that all employeesrequiring access complete annual Information Assurance (IA) training, and maintain a current requisite backgroundinvestigation.  The Contractor’s Security Representative shall contact the Command Security Manager for guidancewhen reinvestigations are required. 

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Security Approval Process

The Contractor’s Security Representative shall ensure that each individual employee pending assignment shallaccurately complete the required forms for submission to the Navy Command Security Manager.  The Contractor’sSecurity Representative shall screen the investigative questionnaires for completeness and accuracy and for potentialsuitability/security issues prior to submitting the request to the Navy Command’s Security Manager.  Forms andfingerprint cards may be obtained from the Navy Command’s Security Manager.  These required items, shall beforwarded to the Navy Command's Security Manager for processing at least 30 days prior to the individualemployee’s anticipated date for reporting for duty.  The Navy Command’s Security Manager will review thesubmitted documentation for completeness prior to submitting it to the Office of Personnel Management (OPM). Suitability/security issues identified by the Navy Command’s Security Manager may render the contract employeeineligible for the assignment.  A favorable review of the questionnaire and advance fingerprint results are required asan interim measure prior to the contract employee start date.  An unfavorable determination made by the NavyCommand’s Security Manager is final and such a determination does not relieve the contractor from meeting anycontractual obligation under the contract.  If contractor employees already possess a current favorably adjudicatedinvestigation, the Navy Command’s Security Manager will use the Visit Authorization Request (VAR) via the JointPersonnel Adjudication System (JPAS).  The contractor shall include the IT Position Category per SECNAVM-5510.30 for each employee designated on a VAR.  The VAR requires annual renewal for the duration of theemployee’s performance under the contract.

The Navy Command’s Security Manager will forward the required forms to OPM for processing.  Once theinvestigation is complete, the results will be forwarded by OPM to the DON Central Adjudication Facility (CAF)for a determination.  When a favorable determination is not made, contractor employees shall not be permitted towork on this contract effort and if already working on the contract shall be removed immediately. 

The potential consequences of any requirements under this clause including denial of access for a proposed contractoremployee who fails to obtain a favorable determination in no way relieves the contractor from the requirement toexecute performance under the contract within the timeframes specified in the contract.  Contractors shall plan aheadin processing their employees and subcontractor employees. The contractor shall insert this clause in allsubcontracts when the subcontractor is permitted to have physical access to a federally controlled facility and/oraccess to a federally-controlled information system/network and/or access to government information.

13.  QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

CONTRACT DESCRIPTION: PROJECT MANAGEMENT SUPPORT FOR BUMED PDHRA PROGRAM

Performance Requirement Performance Standard Acceptable Quality Level

a. Provide monthly report ofservices/activities performedand an annual summary reportof accomplishments, activities,problems, and resolutions atthe end of each contractperiod.

Work products must be accurately reflect thePDHRA field data collected, provide asound analysis of on-going managerialprogram adjustments and present allinformation in a clear and concise manner.   

Rewrites because of errors in fact orjudgment should occur in no more than10% of work products.  Rewrites due toeditorial preferences or to change focusor emphasis of points within thedocument may occur more frequently.

b.  Provide timelycoordination with Navy,Marine and outside agencyrepresentatives; timelyassessment of reportedPDHRA activity; and providetimely briefing and reportingmaterials. 

Continuous coordination must be made withCall Center contractors, field representativesor commanders on PDHRA program issues;monthly data gathering and reporting ofPDHRA workload data must be precise, andall information obtained is thoroughlyanalyzed for forecasts and recommendationspresented in briefings and reports. 

Continual coordination with Navy andMarine field representatives orcommanders is made 100% of the time;and all forecasts and reports areaccurately prepared in advance ofrequired timeframes no less than 90% ofthe time.

c.  Collect, review andevaluate PDHRA workloaddata and coordinateobservations, lessons learnedand recommendations forprocess or technologyimprovement on a weeklybasis. 

Raw PDHRA workload data on the numberof screenings conducted, number ofappointments made and number of referralsprovided must be gathered on a monthlybasis.

100% of available PDHRA workloaddata from Navy Deployment HealthClinics and Reserve Components isobtained and utilized.

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d.  Service as a resource foradvice on programimplementation issues andfacilitate NEHC training ofweb-based tools to the field. 

Be well versed on all PDHRA programpolicy and procedures and subject matterexpert points of contact.  Maintain opendialog with NECH personnel, maintaincurrent training schedules and understandmechanisms for long distance trainingassistance. 

100% establishment of points of contactwith subject matter experts, Navy,Marine and Reserve Command Units,and NEHC.  Become a subject matterexpert on the PDHRA programparameters within 1 month of contractperformance. 

 

 

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SECTION D PACKAGING AND MARKING

If applicable. all Deliverables shall be packaged and marked IAW Best Commerical Practices.

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SECTION E INSPECTION AND ACCEPTANCE

The following clause is hereby incorporated by reference:

52.246-4 - Inspection of Services - Fixed Price (Aug 1996)

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SECTION F DELIVERABLES OR PERFORMANCE

The periods of performance for the following Items are as follows:

   

5000 3/29/2014 - 3/28/2015

6000 3/29/2014 - 3/28/2015

8100 3/29/2015 - 8/31/2015

8102 9/1/2015 - 3/28/2016

8200 3/29/2016 - 3/28/2017

9100 3/29/2015 - 3/28/2016

9200 3/29/2016 - 3/28/2017

CLIN - DELIVERIES OR PERFORMANCE

The periods of performance for the following Items are as follows:

 

5000                                                                                            3/29/2014 - 3/28/2015

6000                                                                                            3/29/2014 - 3/28/2015

  

The periods of performance for the following Option Items are as follows:

 8100                                                                                            3/29/2015 - 3/28/2016

8200                                                                                            3/29/2016 - 3/28/2017

9100                                                                                            3/29/2015 - 3/28/2016

9200                                                                                            3/29/2016 - 3/28/2017

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SECTION G CONTRACT ADMINISTRATION DATA

                    

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JUN 2012)

 (a) Definitions. As used in this clause--

    Department of Defense Activity Address Code (DoDAAC) is a six position code that uniquely identifies a unit,activity, or organization.

    Document type means the type of payment request or receiving report available for creation in Wide AreaWorkFlow (WAWF).

    Local processing office (LPO) is the office responsible for payment certification when payment certification is doneexternal to the entitlement system.

    (b) Electronic invoicing. The WAWF system is the method to electronically process vendor payment requestsand receiving reports, as authorized by DFARS 252.232-7003, Electronic Submission of Payment Requests andReceiving Reports.

   (c) WAWF access. To access WAWF, the Contractor shall--

    (1) Have a designated electronic business point of contact in the Central Contractor Registration athttps://www.acquisition.gov; and

    (2) Be registered to use WAWF at https://wawf.eb mil/ following the step-by-step procedures for self-registrationavailable at this Web site.

    (d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based TrainingCourse and use the Practice Training Site before submitting payment requests through

WAWF. Both can be accessed by selecting the ``Web Based Training'' link on the WAWF home page athttps://wawf.eb.mil/.

    (e) WAWF methods of document submission. Document submissions may be via Web entry, Electronic DataInterchange, or File Transfer Protocol.

    (f) WAWF payment instructions. The Contractor must use the following information when submitting paymentrequests and receiving reports in WAWF for this contract/order:

    (1) Document type. The Contractor shall use the following document type(s).

 Select 2 for 1 for FFP Services

 (Contracting Officer: Insert applicable document type(s). Note: If a ``Combo'' document type is identified but notsupportable by the Contractor's business systems, an ``Invoice'' (stand-alone) and

``Receiving Report'' (stand-alone) document type may be used instead.)

    (2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) inWAWF, as specified by the contracting officer.

N00018

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(Contracting Officer: Insert inspection and acceptance locations or ``Not applicable.'')

   (3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill inapplicable fields in WAWF when creating payment requests and receiving reports in the

system.

                            Routing Data Table*

------------------------------------------------------------------------

            Field Name in WAWF               Data to be entered in WAWF

------------------------------------------------------------------------

Pay Official DoDAAC                      HQ0338

Issue By DoDAAC                           N00189

Admin DoDAAC                                S2404A

Inspect By DoDAAC                        N00018

Ship To Code                                     N00018

Ship From Code                                   - 

Mark For Code                                    -

Service Approver (DoDAAC)          -

Service Acceptor (DoDAAC)            N00018

Accept at Other DoDAAC                 N/A

LPO DoDAAC                                      N00018

DCAA Auditor DoDAAC                  -

Other DoDAAC(s)                              -

------------------------------------------------------------------------

 (*Contracting Officer: Insert applicable DoDAAC information or ``See schedule'' if multiple ship to/acceptancelocations apply, or ``Not applicable.'')

    (4) Payment request and supporting documentation. The Contractor shall ensure a payment request includesappropriate contract line item and subline item descriptions of the work performed or supplies delivered, unitprice/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F,(e.g. timesheets) in support of each payment request.

  (5) WAWF email notifications. The Contractor shall enter the email address identified below in the ``SendAdditional Email Notifications'' field of WAWF once a document is submitted in the system.

  (g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting

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activity's point of contact.

(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

 (End of clause)

  

AVAILABILITY OF FUNDS:

Funding provided hereunder for CLINS 5000 and 6000 are subject to the Continuing Resolution Acts, if any, andthe final FY 14 Appropriations Act passed by Congress.  This funding is released for the period of time covered bythe Continuing Resolution Act (CRA), in an amount proportionate to the period of time covered by CRA.  Uponapproval of further CRAs, if any, funding is released for the period of time covered by the additional CRA(s), in anamount proportionate to the amount of time covered by any additional CRA(s).  The funding becomes fullyavailable upon passage of the FY 14 Appropriations Act.

 

AVAILABILITY OF FUNDS (FAR 52.232-18) (APR 1984)

 Funds are not presently available for this contract.  The Government’s obligation under this contract is contingentupon the availability of appropriated funds from which payment for contract purposes can be made.  No legalliability on the part of the Government for any payment may arise until funds are made available to the ContractingOfficer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by theContracting Officer.

  

 

8(a) TASK ORDER MODIFICATION DISTRIBUTION

 In accordance with the Memorandum of Agreement between the Department of Navy and the Small BusinessAdministration (SBA) the successful Quoter shall provide their cognizant SBA district office with a copy of theexecuted Task Order and all subsequent modifications to the Task Order within five (5) workdays of receipt. 

 

  

APPOINTMENT OF CONTRACTING OFFICER’S REPRESENTATIVE (FISC DET PHILA) (OCT 1992)

 (a)  The Contracting Officer hereby designates the following individual as Contracting Officer’s Representative(s)(COR) for this contract:

                                                                                                                                                    

                                               

                               

 (b)  In the absence of the COR named above, all responsibilities and functions assigned to the COR shall be theresponsibility of the alternate COR acting on behalf of the COR.  The Contracting Officer hereby appoints thefollowing individual as the alternate COR:

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                __________________________________________

                NAME                                                                   CODE

                 __________________________________________

                MAIL ADDRESS

                 __________________________________________

                TELEPHONE NUMBER

 

 (c)  The COR will act as the Contracting Officer’s representative for technical matters, providing technical directionand discussion as necessary with respect to the specification or statement of work, and monitoring the progress andquality of contractor performance.  The COR is not an Administrative Contracting Officer and does not haveauthority to take any action, either directly or indirectly, that would change the pricing, quantity, quality, place ofperformance, delivery schedule, or any other terms and conditions of the contract (or delivery/task order), or to directthe accomplishment of effort which goes beyond the scope of the statement of work in the contract (or delivery/taskorder).

 (d)  It is emphasized that only a Contracting officer has the authority to modify the terms of the contract, therefore,in no event will any understanding, agreement, modification, change order, or other matter deviating from the termsof the basic contract between the contractor and any other person be effective or binding on the Government. When/if, in the opinion of the contractor, an effort outside the existing scope of the contract (or delivery/task order)is requested, the contractor shall promptly notify the PCO in writing.  No action shall be taken by the contractorunder such direction unless the PCO or ACO has issued a contractual change or otherwise resolved the issue.

REIMBURSEMENT OF TRAVEL COSTS  (OCT 1998)

 (a)  Travel

                 (1)  Area of Travel.  Performance under this contract may require travel by contractor personnel.  Iftravel, domestic or overseas, is required, the contractor is responsible for making all needed arrangements for hispersonnel.  This includes but is not limited to the following: Medical Examinations,  Immunization, Passports,visas, etc., Security Clearances.

                 All contractor personnel required to perform work on any U.S. Navy vessel will have to obtainboarding authorization from the Commanding Officer of the vessel prior to boarding.

                (2)  Travel Policy.  The Government will reimburse the contractor for allowable travel costs incurred bythe contractor in performance of the contract and determined to be in accordance with FAR subpart 31.2, subject tothe following provisions:

                 Travel required for tasks assigned under this contract shall be governed in accordance with rules setforth for temporary duty travel in FAR 31.205-46.

                (3)  Travel.  Travel, subsistence, and associated labor charges for travel time are authorized, whenever atask assignment requires work to be accomplished at a temporary alternate worksite.

                 Travel performed for personal convenience and daily travel to and from work at contractor’s facility willnot be reimbursed.

                 (4)  Per Diem.  Per diem for travel on work assigned under this contract will be reimbursed toemployees consistent with company policy, but not to exceed the amount authorized in the Department of DefenseJoint Travel Regulations.

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                 (5)  Shipboard Stays.  Whenever work assignments require temporary duty aboard a Government ship,the contractor will be reimbursed at the per diem rates identified in paragraphs C8101.2C or C81181.3B(6) of theDOD Joint Travel Regulations, Volume 2.

                 (6)  Air/Rail Travel.  In rendering the services, the contractor shall be reimbursed for the actual costs oftransportation incurred by its personnel not to exceed the cost of tourist class rail, or plane fare, to the extent thatsuch transportation is necessary for the performance of the services hereunder and is authorized by the OrderingOfficer.  Such authorization by the Ordering Officer shall be indicated in the order or in some other suitable writtenform.

                 NOTE:  To the maximum extent practicable without the impairment of the effectiveness of the mission,transportation shall be tourist class.  In the event that only first class travel is available, it will be allowed, providedjustification therefore is fully documented and warranted.

                 (7)  Private Automobile.  The use of privately owned conveyance within the continental United Statesby the traveler will be reimbursed to the contractor at the mileage rate allowed by Joint Travel Regulations. Authorization for the use of privately owned conveyance shall be indicated on the order.  Distances traveled betweenpoints shall be shown in standard highway mileage guides.  Any deviations from distance shown in such standardmileage guides shall be explained by the traveler on his expense sheet.

                 (8)  Car Rental.  The contractor shall be entitled to reimbursement for car rental, exclusive of mileagecharges, as authorized by each order, when the services are required to be performed outside the normal commutingdistance from the contractor’s facilities.  Car rental for TDY teams will be limited to a rate of one car for every four(4) persons on TDY at one site.  

 (End of Provision)

CLAUSES INCORPORATED BY REFERENCE

 DFARS 252.201-7000 Contracting Officer’s Representative

Accounting Data

  

  

  

  

  

   

  

  

    

  

  

   

 

  

  

  

  

 

  

  

  

  

  

  

  

  

   

  

  

    

  

  

  

  

   

  

  

 

 

  

  

  

  

 

SECTION H SPECIAL CONTRACT REQUIREMENTS

Not applicable.

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SECTION I CONTRACT CLAUSES

Section I 

52.217-9     OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

 (a)  The Government may extend the term of this contract by written notice to the Contractor 30 days prior to thecontract expiration.

 (b)   If the Government exercises this option, the extended contract shall be considered to include this optionclause.

 (c)   The total duration of this contract, including the exercise of any options under this clause, shall not exceed 36months.

 (End of clause)

52.217-8     OPTION TO EXTEND SERVICES (NOV 1999)

 The Government may require continued performance of any services within the limits and at the rates specified inthe contract.  These rates may be adjusted only as a result of revisions to prevailing labor rates provided by theSecretary of Labor.  The option provision may be exercised more than once, but the total extension of performancehereunder shall not exceed 6 months.  The Contracting Officer may exercise the option by written notice to theContractor within 30 days of contract expiration.

 (End of clause)

 

ECMRA

 Enterprise-wide Contractor Manpower Reporting Application (ECMRA)

 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required forperformance of services provided under this contract for the Administrative Support Services via a secure datacollection site.  The contractor is required to completely fill in all required data fields using the following webaddress:  https://doncmra.nmci navy mil.

 Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year(FY), which is October 1 through September 30.  While inputs may be reported any time during the FY, all datashall be reported no later than October 31 of each calendar year.  Contractors may direct questions to the help desk,linked at https://doncmra.nmci navy mil.

 

(End of clause)

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SECTION J LIST OF ATTACHMENTS

Contract Administration Plan

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