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Title of Project: Gulf War and Health: Treatments for Multi-Symptom Illness 2. Scope of Work: a. The scope of this project on this significant military and Veteran health issue will address the best treatments for chronic multi-symptom illness in Gulf War Veterans. The Institute of Medicine (IOM) shall comprehensively review, evaluate, and summarize the available scientific and medical literature regarding the best treatments for chronic multi-symptom illness among Gulf War Veterans. In evaluating the best treatments for chronic multi-symptom illness among Gulf War Veterans, the committee should look broadly for relevant information. Information sources to pursue could include, but are not limited to: i. Published peer-reviewed literature concerning the treatment of multi-symptom illness among the 1991 Gulf War Veteran population; ii. Published peer-reviewed literature concerning treatment of multi-symptom illness among OEF (Operation Enduring Freedom), OIF (Operation Iraqi Freedom), and New Dawn active duty Service members and Veterans; iii. Published peer-reviewed literature concerning treatment of multi-symptom illness among similar populations such as Allied military personnel; and iv. Published peer-reviewed literature concerning treatment of populations with a similar constellation of symptoms. c. Section 806 of Public Law 111-275, Veterans’ Benefit Act of 2010, requires, for purposes of reports under other statutes concerning the health effects of exposures in the Persian Gulf War, the disaggregation of results for exposures occurring in (1) the Southwest Asia theater of operations for the period of the Persian Gulf War ending on September 11, 2001, and (2) the Post-9/11 Global Theaters of Operations for the Period of the Persian Gulf War beginning on September 11, 2001. To assist in review and future decision-making, the IOM shall disaggregate to the degree possible, all determinations, discussions, results, and recommendations described in this agreement and submit such material separately for each of the following Veteran populations: 1) U.S. military personnel deployed to the Southwest Asia theater of operations between August 2, 1990, and September 11, 2001; and, 2) U.S. military personnel deployed after September 11, 2001, to the Southwest Asia theater of operations.
d. IOM will submit a report to the Secretary of the VA and Committees on Veterans’ Affairs of the Senate and House of Representatives no later than December 31, 2012. e. Pursuant to public law, the committee assembled by the IOM for the study shall obtain input from a group of medical professionals who are experienced in treating Gulf War Veterans who have been diagnosed with chronic multi-symptom illness or other health conditions related to chemical and environmental exposure that may have occurred during service in the Armed Forces in the Southwest Asia Theater of Operations. In addition to summarizing the available scientific and medical literature regarding the best treatments for chronic multisymptom illness among Gulf War Veterans, the IOM shall: i. Recommend how best to disseminate this information throughout the VA to improve the care and benefits provided to Veterans. ii. Recommend additional scientific studies and research initiatives to resolve areas of continuing scientific uncertainty. iii. Recommend such legislative or administrative action as the IOM deems appropriate in light of the results of its review.
Definitions: a. Per 38 U.S.C. §101(33), the Persian Gulf War began August 2, 1990, and shall continue until the date thereafter prescribed by Presidential proclamation or by law. The IOM shall apply the definition of “Southwest Asia theater of operations” as stated in VA regulation 38 CFR 3.317(d) (2): “Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations.” b. The term “chronic multi-symptom illness in Gulf War Veterans” means chronic multi-symptom illness defined by a cluster of signs and symptoms manifest in Veterans who served in the Gulf War, typically including widespread pain, persistent memory and concentration problems, chronic headaches, gastrointestinal problems and other abnormalities not explained by well-established diagnosis, per Pub. L. 111-275(e) (1).
4. Background: In 1998, the IOM began a series of studies on examining long-term health outcomes associated with biologic and chemical exposures that might have been experienced during the 1990 Gulf War. Although the Gulf War was a brief military operation (the war began in August 1990, and the last US ground troops returned home by June 1991), many Veterans began reporting a variety of unexplained health problems that they attributed to their participation in the Gulf War, including chronic fatigue, muscle and joint pain, loss of concentration, forgetfulness, headache and rash. One response to concerns about the Veterans’ health problems was a request by the Department of Veterans Affairs (VA) that the Institute of Medicine (IOM) review the scientific and medical literature on the long-term adverse health effects of agents to which the Gulf War Veterans may have been exposed. Congress, responding to the growing concerns of ill Veterans, passed legislation in 1998 (the Gulf War Veterans Act, Pub. L. 105-277, and the Veterans Programs Enhancement Act, Pub. L. 105-368) for a study similar to that previously requested by VA. The two laws, Pub. L. 105-277 and Pub. L. 105-368, listed numerous biological and chemical agents for study and the IOM has reviewed most of those agents since 1998. Most recently, Congress passed legislation (Veterans’ Benefits Act of 2010, Pub. L 111-275) requiring the Secretary of Veterans Affairs to enter into an agreement with the Institute of Medicine of the National Academies to carry out a comprehensive review of the best treatments for chronic multi-symptom illness in Gulf War Veterans. Pub. L. 111-275 also requires an evaluation of how such treatment approaches could best be disseminated throughout the Department of Veterans Affairs to improve the care and benefits provided to veterans. VA and potentially affected Veterans and their families will be well served in the end by having an authoritative evaluation of this Gulf War Veterans’ health issue. It will also help VA respond to related inquiries, plan for health care for affected Veterans, and educate VA providers on this issue. 5. Performance Period: The period of performance is 21 months from the date of the award. 6. Type of Contract: Cost Reimbursement Task Order 7. Place of Performance: National Academy of Sciences, Institute of Medicine 500 Fifth St. NW. Washington, DC 20001. B. CONTRACT AWARD MEETING A kick off meeting is waived. C. GENERAL REQUIREMENTS VHA will receive a final copy of the report 10 calendar days prior to public release. IOM does not provide draft reports. D. SPECIFIC MANDATORY TASKS AND ASSOCIATED DELIVERABLES Task 1: The IOM will provide monthly status updates on the progress of the study. Deliverable 1: Monthly status updates. Task 2: The IOM will submit a prepublication copy of the report, prior to completion of the term of this contract, identifying the best treatments for chronic multi-symptom illness in Gulf War Veterans and an evaluation of how such treatment approaches could best be
disseminated throughout the Department of Veterans Affairs. This report will include the committee's determinations, discussions and any relevant recommendations. Deliverable 2: Submit 60 IOM pre-publication copies of the pre-publication report 17 months after contract award. Task 3: The IOM will provide a final report of the IOM report intended to help inform the VA and other interested stakeholders, including US Congress. Deliverable 3: Provide 400 copies of the final IOM consensus report 21 months after contract award. E. EVALUATED OPTIONAL TASKS AND ASSOCIATED DELIVERABLES Not Applicable F. SCHEDULE FOR DELIVERABLES If for any reason the scheduled time for a deliverable cannot be met, the contractor is required to explain why (include the original deliverable due date) in writing to the CO, including a firm commitment of when the work will be completed. This notice to the CO will cite the reasons for the delay, and the impact on the overall project. The CO will then review the facts and issue a response in accordance with the Federal Acquisition Regulation. G. CHANGES TO STATEMENT OF WORK Any changes to this SOW will be authorized and approved only through written correspondence from the CO. A copy of each change will be kept in a project folder along with all other products of the project. Costs incurred by the contractor through the actions of parties other than the CO will be borne by the contractor. H. REPORTING REQUIREMENTS Shown in Attachment A – Schedule of Deliverables I. TRAVEL Foreign Travel and per diem will be reimbursed in accordance with Federal Travel Regulations. At least one of the meetings will be held away from Washington DC in order to balance the travel responsibilities of IOM committee members living in different parts of the country. J. CONTRACTOR EXPERIENCE REQUIREMENTS – KEY PERSONNEL These skilled experienced professional and/or technical personnel are essential for successful contractor accomplishment of the work to be performed under this contract and subsequent task orders. These are defined as key personnel and are those persons whose résumés were submitted. The contractor agrees that the key personnel will not be removed, diverted, or replaced from work without notification to the CO and COTR. Any personnel the contractor offers as substitutes will have the ability and qualifications equal to or better than the key personnel who is being replaced. K. ELECTRONIC AND INFORMATION TECHNOLOGY STANDARDS SECTION 508 The contractor will comply with Section 508 of the Rehabilitation Act (29 U.S.C. § 794d), as amended by the Workforce Investment Act of 1998 (P.L. 105-220), August 7, 1998.
In December 2000, the Architectural and Transportation Barriers Compliance Board (Access Board), pursuant to Section 508(2) (A) of the Rehabilitation Act Amendments of 1998, established Information Technology accessibility standards for the Federal Government. Section 508(a)(1) requires that when Federal departments or agencies develop, procure, maintain, or use Electronic and Information Technology (EIT), they will ensure that the EIT allows Federal employees with disabilities to have access to and use of information and data that is comparable to the access to and use of information and data by other Federal employees. The Section 508 requirement also applies to members of the public seeking information or services from a Federal department or agency. Section 508 text is available at: http://www.opm.gov/HTML/508-textOfLaw.htm http://www.section508.gov/index.cfm?FuseAction=Content&ID=14 L. RIGHTS IN DATA - COPYRIGHT It is agreed that: 1. The IOM will own all copyrights in materials first produced under the task order. However, the Government will be given a royalty-free, non-exclusive license to use or reproduce any such materials or to authorize others to do so. The IOM asserts its copyright ownership only to materials or to authorize others to do so. The copyright ownership is to be used only to further the IOM’s policy of maximum public dissemination. 2. Any reference made to the Government's right concerning access to information and data related to this award does not include committee minutes, working papers, vote tallies, transcripts, report drafts and other records of deliberation particularly of IOM committees in closed session. This material is considered to be privileged information and not subject to dissemination outside of the IOM. POINT OF CONTACT: For questions, contact Rebecca Crawford at 202-461-1060. M. Security Requirements for Unclassified Information Technology Resources (a) The contractor and their personnel will be subject to the same Federal laws, regulations, standards and VA policies as VA personnel, regarding information and information system security. These include, but are not limited to Federal Information Security Management Act (FISMA), Appendix III of OMB Circular A-130, and guidance and standards, available from the Department of Commerce’s National Institute of Standards and Technology (NIST). This also includes the use of common security configurations available from NIST’s Web site at: http://checklists.nist.gov/. (b) To ensure that appropriate security controls are in place, Contractors must follow the procedures set forth in “VA Information and Information System Security/Privacy Requirements for IT Contracts” located at the following Web site: http://www.iprm.oit.va.gov/.
Attachment A Schedule of Deliverables Deliverable No. 1 Item Provide monthly status reports on the progress of the study. Quantity 18 Delivery Date Monthly
Prepublication copy of the report describing all of the committee’s work and present its findings. Final copy of the report
17 months after contract award
21 months after contract award
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