B01 12318720R0001 OSOH WO Wellness Program RFP.pdf

United States Forest Washington Office 1400 Independence Ave, SW Department of Service Washington, DC 20250 Agriculture

COMBINED SYNOPSIS / SOLICITATION

IAW FAR 12.6 Streamlined Procedures for Evaluation and Solicitation of Commercial Items

USDA Forest Service Washington Office Assessments, Appraisals, and Counseling, Seminars and Workshops

(1) Action Code: N/A

(2) Date: January 23, 2020

(3) Year: FY2020

(4) Contracting Office ZIP Code: 20024

(5) Product or Service Code (PSC): Q403 – Medical - Evaluation / Screening

(6) Contracting Office Address: USDA Forest Service Sidney R. Yates Federal Building 201 14th St, SW Washington, DC 20250

(7) Subject: USDA Forest Service Washington Office Assessments, Appraisals, and Counseling, Seminars and Workshops

(8) Solicitation Number: 12318720R0001

(9) Closing Response Date: February 3, 2020

(10) Contact Point or Contracting Officer: Dana Price, CFCM Contract Specialist

(11) BPA Award Number: UNKNOWN and Solicitation Number: 12318720R0001

(12) BPA Award Dollar Amount: Estimated NTE $240,000.00

(13) Line Item Number: BPA CLIN Structure Per the SOW, approximately 70 employees participate each quarter for health assessments, fitness assessments, health risk appraisals and prescription counseling;

about 100 participate in the annual health fair and seminars.

CLINs 001-004 Price shall be provided per individual employee, per event for CLINs 001-004. The total for a single event and the sum total price for four quarterly events is not required in a proposal and will not be accepted in lieu of a proposed price per individual.

CLINs 005-008 Price shall be provided per event based on the estimated number of employees. Price for individual employees is not required and will not be accepted in lieu of a proposed price per event.

DELIVERABLES

CLIN Description Unit BPA Year I BPA Year II BPA Year III BPA Year IV BPA Year V 001 Quarterly Health Assessment per person $ $ $ $ $ 002 Quarterly Fitness Assessment per person $ $ $ $ $ 003 Quarterly Health Risk Appraisal per appraisal $ $ $ $ $ 004 Quarterly Prescription Counseling1 per person $ $ $ $ $ 005 Wellness Seminars2 per seminar $ $ $ $ $ 006 Annual Wellness Fair per fair $ $ $ $ $

OPTIONAL CLINs CLIN Description Unit BPA Year I BPA Year II BPA Year III BPA Year IV BPA Year V 007 Additional Wellness Seminar(s) per seminar $ $ $ $ $ 008 Additional Wellness Fair(s) per fair $ $ $ $ $

1 Includes Employee Reports 2 Up to eight per fiscal year

The following is the anticipated schedule of deliverables and is typical for each quarter:

Part 1 – Lab Work – one four-hour session Part 2 – Fitness Testing – one four-hour session Part 3 – Individual Counseling – one four-hour session

See the SOW and WO Wellness Plan (attached) for requirement parameters.

Quarters (follow federal fiscal year) 1st Quarter: October – December 2nd Quarter: January – March 3rd Quarter: April – June 4th Quarter: July – September

(14) Contract Award Date: Anticipated 2/7/2020

(15) Contractor: UNKNOWN

(16) Description:

The USDA FS intends to award a single-award Blanket Purchase Agreement (BPA) and first Call Order to meet Wellness Program requirements. The Government estimates, but does not guarantee, the volume of Call Orders through this will be no more than quarterly.

Specific requirements and funds will be detailed and obligated at the Call Order level.

USDA Forest Service seeks a contractor to provide primary preventive services as part of the Washington Office (WO) Wellness Program for approximately 700 employees located in the Washington metropolitan area. About 70 employees participate each quarter for the health assessments and about 100 for the for the annual health fair. The employee population/address is as follows:

Location Employee Population

Yates Building 700 14th & Independence, SW Washington, D.C. 20090

The primary objective of the WO Wellness Program is to institute a workplace wellness program which facilitates both voluntary individual and management adaptation of behavior that leads to improved health and heightened life satisfaction for individual employees within their family culture and thereby, over time, reduce management liability (illness and injury and the associated costs--direct and indirect).

See attached Statement of Work (SOW), including the WO Wellness Plan FY2020 for complete requirement details.

(i) This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.

(ii) 12318720R0001 is issued as a request for proposal (RFP)

(iii) The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2020-01/11-12-2019.

(iv) This requirement is being set-aside and the associated NAICS code and small business size standard is: 621999 – All Other Miscellaneous Ambulatory Health Care Services - $16.5M

(v) A list of line item number(s) and items, quantities, and units of measure (including option(s), if applicable) – See (13) above

(vi) See Statement of Work (SOW) and WO Wellness Plan.

(vii) Date(s) and place(s) of delivery and acceptance and FOB point: Call Order specific.

(viii) The provision at 52.212-1, Instructions to Offerors-Commercial, applies to this acquisition and are incorporated by reference. Addenda are attached.

(ix) The provision at 52.212-2, Evaluation-Commercial Items, applies to this acquisition.

Addenda are attached.

(x) Offerors are required to include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Items, with its offer:

The offeror shall complete only paragraph (b) of this provision since they must be registered in the System for Award Management (SAM) as accessed through https://www.sam.gov in order to respond to solicitations and be awarded contracts.

(xi) The clause at 52.212-4, Contract Terms and Conditions-Commercial Items, applies to this acquisition. Addenda are attached.

https://www.sam.gov/ https://www.sam.gov/

(xii) The clause at 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Items, applies to this acquisition; indicated additional FAR clauses cited in the clause are applicable to the acquisition.

(xiii) A statement regarding any additional contract requirement(s) or terms and conditions (such as contract financing arrangements or warranty requirements) determined by the contracting officer to be necessary for this acquisition and consistent with customary commercial practices.

(xiv) The Defense Priorities and Allocations System (DPAS) and assigned rating is not applicable.

(xv) Proposals are due February 3, 2020 at 12:00p via email to the Solicitation POC.

(xvi) Solicitation POC: Dana L Price, CFCM, Contract Specialist, dana.price2@usda.gov.

(17) Place of Contract Performance: USDA Forest Service, Yates Federal Building, Washington, DC.

BPA Period of Performance BPA Year I: February 7, 2020 – February 6, 2021 BPA Year II: February 7, 2021 – February 6, 2022 BPA Year III: February 7, 2022 – February 6, 2023 BPA Year IV: February 7, 2023 – February 6, 2024 BPA Year V: February 7, 2024 – February 6, 2025

1st Call Order (awarded at BPA award) February 7, 2020 – September 30, 2020

• 2nd Quarter Assessment (Jan-Mar) o *2/TBD (lab); 2/TBD (fitness); 2/TBD (counseling)

• 3rd Quarter Assessment (Apr-Jun) o 4/14 (lab); 4/16 (fitness); 4/28 (counseling)

• 4th Quarter Assessment (Jul-Sep) o 9/8 (lab); 9/10 (fitness); 9/11 (counseling)

• Annual Health Fair o 9/9 (includes promotional items/giveaways)

*Final dates (anticipated 3rd week of February) will be provided when finalized as an amendment to the Combined Synopsis/Solicitation or at Call Order award.

(18) Set-aside Status: This requirement is being set-aside for Small Business (SB).

ATTACHMENT(S):

Statement of Work (SOW) WO Wellness Plan

STATEMENT OF WORK FOR WELLNESS PROGRAM

USDA Forest Service Washington Office Assessments, Appraisals, and Counseling, Seminars, and Workshops

A. Scope

USDA Forest Service seeks a contractor to provide primary preventive services as part of the Washington Office (WO) Wellness Program for approximately 700 employees located in the Washington metropolitan area. About 70 employees participate each quarter for the health assessments and about 100 for the for the annual health fair. The employee population/address is as follows:

Location Employee Population

Yates Building 700 14th & Independence, SW Washington, D.C. 20090

The primary objective of the WO Wellness Program is to institute a workplace wellness program which facilitates both voluntary individual and management adaptation of behavior that leads to improved health and heightened life satisfaction for individual employees within their family culture and thereby, over time, reduce management liability (illness and injury and the associated costs--direct and indirect).

Participation in the WO Wellness Program is strictly voluntary. The present rate of participation in primary preventive services offered is significant. Primary preventive services, as defined in paragraph b below, are to emphasize the identification and quantification of personal habits that affect the risk of disease and on the alteration of these habits to reduce specific disease risks.

USDA Forest Service is an equal opportunity employer and has several physically challenged employees in the WO. The contractor shall address methods available to encourage their participation. Also, the contractor's proposal shall demonstrate awareness and ability to provide specialized individual lifestyle prescriptions to physically challenged employees.

B. Minimum Technical Requirments

1. Primary Preventive Services. Over three (3) separate days, primary preventive services shall include health and fitness assessments; health risk appraisal;

and individual based prescription counseling sessions. Assessments and appraisals (health screenings) shall be conducted by skilled and professional contractor employees on a quarterly basis to ensure that all WO employees (to include reassignments and new hires) have opportunity to participate in the assessments and appraisals within reasonable time frames in a given fiscal year. The location for the assessments, appraisals, and counseling sessions shall be on a quarterly basis at the Yates building. Periodically, we might have an assessment or seminar at the Yates building. As a minimum, primary preventive services shall consist of the following elements and conclude with individual counseling sessions:

(a) Health Assessment. This medical screening, as a minimum, shall include the following aspects with a physician's review of all health assessment results:

1. SMAC 24 (complete blood count).

2. TC, HDL, LDL, TRI, GLU.

3. Blood lipid profile.

4. Prostatic specific antigen (PSA).

5. Thyroid function test.

(b) Fitness Assessment. This physical fitness assessment, as a minimum, shall include the following screenings:

1. Body composition analysis screening.

2. Height measurement.

3. Weight measurement.

4. Cardiovascular fitness screening.

(i) Resting heart rate measurement.

(ii) Blood pressure measurement.

(iii) Step Test.

5. Other Fitness Tests

(i) Flexibility

(ii) Grip Strength

(c) Health Risk Appraisal. This health risk appraisal, as a minimum, shall consist of a questionnaire (written questionaire are perferred, as employee will not take the time to do the electronic questionnaries) which addresses the following profiles:

(i) Fitness profile.

(ii) Nutritional profile.

(ii) Stress profile.

(iv) Smoking/alcohol profile.

(v) Medical history profile.

(vi) Safety factors profile.

(vii) Seminars/workshops preferred by the employee (this should be accomplished through a checklist of health promotion topics, which has been approved by the WO Wellness Program Manager).

(d) Individual Based Prescription Counseling. Individual based prescription counseling sessions shall be conducted after each quarterly health screening cycle predicated on high risk factors identified through health and fitness assessments and health risk appraisals. Such individual based prescription counseling sessions shall provide follow-on to the individual, especially high risk employees. Individual sessions should address recommended nutritional guidelines, lifestyle modifications, and exercise/fitness activities, as appropriate.

As a component of employee reports, the contractor agrees to complete the enclosed Partcipation in Agency’s Health Assessements Form) for each participating employee.

C. Employee Reports

Employee reports shall be provided to participating employees at the next scheduled individual based prescription counseling sessions or by other mutually agreed upon means, e.g., U.S. Mail (if an employee elects not to participate in the counseling sessions). Individual assessment and appraisal results shall remain confidential between the WO employee and contractor. As a minimum, employee reports shall include the following:

1. Health assessment results.

2. Fitness assessment results.

3. Health risk appraisal results.

4. Washington Office Particpation in the Agency’s Health Assessments Form.

5. Individual Intervention Plans (as required).

D. Primary Preventive Services Promotion.

To ensure maximum participation, the contractor shall provide publicity for all primary preventive services. Publicity shall include posters and flyers and should include handouts, briefings, or other appropriate actions. Such publicity shall be positive, up beat and creative and appealing to members of a multicultural organization. The WO Wellness Program Manager shall determine the appropriateness of all publicity documents, to include aesthetic value, size, color, paper quality, paper color, method of distribution, and location. USDA Forest Service reserves the right to publish information about the program separate and apart from the contractor's effort.

E. Program Reporting and Recordkeeping.

Based on health and fitness assessment and health risk appraisal results, the contractor, as a minimum, shall provide the following reports to the WO Wellness Program Manager:

1. Quarterly summative and formative evaluation report.

2. Year-end impact evaluation report.

F. Wellness Seminars and Workshops.

The contractor shall provide seminar/workshops on health, fitness, and lifestyle topics (2 each quarter or 8 per fiscal year unless otherwise combined, canceled, and/or rescheduled (without penalty) by the WO Wellness Program Program Manager due to lack of interest by participants and/or unforeseen events, i.e., inclement weather and/or Federal Government on liberal leave and/or closed) for an audience normally not to exceed 45 employees. Topics should be identified by the contractor and approved by the WO Wellness Program Manager based on aggregrated health risk appraisal results and quarterly and annual corporate reports provided by the USDA Forest Service.

Seminars/workshops shall average 1-2 hours in length. Instructors shall be certified as experts in their understanding of the wellness topics and shall have demonostrated the capacity to motivate and communicate effectively using various presentation methods (includes the use of handouts, slides, viewgraphs, demonstrations, models, and other appropriate presentation media.)

G. Wellness Seminar and Worshop Literature.

The contractor shall provide each seminar/workshop participant a functional and substantive handout that addresses relevant subject matter on the topic being presented for a given month.

Student handouts shall be be first or second generation copy quality. Such student handouts shall become the property of the Government. Brochures, flyers, and other necessary handouts shall be utilized to support seminar/workhops presentation, as appropriate.

H. Wellness Seminar and Workshop Promotion.

To ensure maximum participation, the contractor shall provide publicity for all seminars/workshops. Publicity shall include posters, flyers, handouts, briefings, and other appropriate actions. Such publicity shall be positive, update, and creative. The WO Wellness Program Manager shall determine the appropriateness of all publicity documents, to include aesthetic value, size, color, paper quality and color, method of distribution, and location. USDA Forest Service reserves the right to public information about seminars/workshops separate and apart from the contractor’s effort.

I. Wellness Seminar and Evaluations.

The contractor shall provide a means of assessing the effectiveness of each seminar/workshop through a partcipant survey. Such survey shall yield sufficient participant feedback so that seminars/workshops can be further developed and refined, as necessary. Copies of the surveys shall be provided to the the WO Wellness Program Manager.

J. Government Furnished Property.

Health and fitness assessments and health risk appraisals shall be conducted at USDA Forest Service Washington Office facilities (locations) listed in paragraph A above. The contractor shall identify space requirements and equipment (e.g., tables, chairs, meeting rooms) that USDA Forest Service can reasonably provide. All other equipment shall be provided by the contractor.

K. Payment, Billing, and Extent of Obligation.

The contractor should indicate the minimum number of WO employees required to conduct health and fitness assessments and health risk appraisals on a quarterly basis, if required. Payment shall be based on the pricing structure agreed upon between USDA Forest Service and the contractor.

Payment shall be made for health and fitness assessments; health risk appraisals; individual based prescription counseling sessions; and associated services authorized by the WO Wellness Program Manager. No condition of sale other than as specified herein or as may be mutually agreed to for a specific order shall be applicable to purchases made under this agreement. USDA Forest Service shall be obligated only to the extent of the primary preventive services and other associated services actually performed under this contract.

U.S. Forest Service

Washington Office Wellness Plan

FY 2020

Table of Contents

General Overview 2

Objective 2

Authorities 2

Administration 3

Components 3

1. Health Assessments 3

2. Physical Fitness Program 4

a. Approved Activities 5

b. Use of Administrative Leave 5

c. Liability 6

3. Wellness Education 6

4. Wellness Reimbursements 6

Funding 7

Monitoring 7

Enclosures Enclosure 1 – Participation in the Agency’s Health Assessments 9 Enclosure 2 – Physician or Health Care Provider’s Authorization 10 Enclosure 3 – Personal Wellness Agreement 11 Enclosure 4 – Guidelines for Wellness Program Reimbursements 13 Enclosure 5 – Frequently Asked Questions (Pending) 14

Washington Office Wellness Plan

General Overview

The Washington Office Wellness Plan encourages the achievement of individual wellness goals that stimulate positive self-images, higher morale, and improve health. The purpose of this program is to create an environment that encourage employees to adopt an active lifestyle, which promotes physical well-being and enhances their ability to lead a satisfying and productive life both on and off the job. The U.S. Forest Service will benefit by increased productivity, reduced absenteeism, and lower Office of Worker's Compensation (OWCP) costs.

Objective

The objective of WO Wellness Program is to improve individual employee fitness as appropriate (i.e., weight loss, flexibility, muscle tone, aerobic capacity, stress reduction, etc.) and encourage personal health maintenance including physical exercise. By providing educational and fitness opportunities which increase knowledge and improve the well being of those in the program, we will bring people together and increase personal effectiveness. Through increased personal and physical well-being, we will reduce absenteeism and accidents and will increase morale.

Authorities

There are several policies which affect the establishment, implementation and funding of the WO Wellness Program. For reference, they are listed below:

1. Title 5, United States Code, section 7901 − Authorizes the head of each agency to establish a health service program to promote and maintain the physical and mental fitness of employees within the limits of available appropriations.

2. Title 5, Code of Federal Regulations, Part 792 − Provides agency requirements for providing Health and Counseling Services.

3. Departmental Regulation 4400-6 (DR 4400-6) dated December 16, 1996 − Establishes the USDA smoking policy including smoking cessation programs.

4. USDA Safety and Health Manual, dated September 1996 (replaced Departmental Regulation 4400-6 dated June 14, 1993) – Provides guidance to agencies to promote wellness that improves employee health, morale, and productivity.

5. Forest Service Manual 6760 (FSM 6760) dated June 11, 2019 − Encourages Forest Service units to establish employee wellness programs which promote active lifestyles to maintain mental and physical well-being, enhance an individual's ability to lead a satisfying and productive life both on and off the job, and reduce Forest Service costs by increasing productivity and reducing illness and injuries.

Administration

1. The WO Office of Safety and Occupational Health administers the WO Wellness Program in accordance with the authorities listed above.

2. The WO Wellness Program provides all eligible employees geographically located in the WO an opportunity to participate in health, fitness, and lifestyle assessments; health maintenance activities that include physical fitness and exercise activities; and wellness educational opportunities such as seminars, workshops, health fairs, and general wellness information such as printed materials, newsletters, and websites.

3. The WO Wellness Program participation is strictly voluntary; however, all employees located in the WO metro area are encouraged to participate.

4. WO detached/virtual employees are encouraged to participate in programs where they are located, if applicable. For wellness expenses, please use your staff’s job code.

5. Employees are encouraged to develop their own personal wellness goals.

However, in order to use administrative leave or appropriated funds, an employee must complete the agency-sponsored health assessments and/or obtain a letter from their health care provider at their expense.

Components

The components of the WO Wellness Program include: 1) health assessments, 2) physical fitness program, 3) health education, and 4) wellness reimbursements.

1. Health Assessments. Health assessments are used to help identify individuals in high-risk categories; and develop an individual exercise or wellness program based on fitness goals and the benefits to the agency. Some examples of high-risk categories are, but not limited to, high blood pressure; family history of heart disease; bone and joint problems; cigarette smoking; and a sedentary lifestyle. Health assessments are conducted on a quarterly basis on-site and are open to all employees at no cost. A schedule of tentative wellness events will be mailed to employees each fiscal year. Flyers on individual events will be mailed to employees at least 2 weeks prior to the scheduled events. The assessment consists of three parts:

• Part 1 – Complete laboratory analysis of your blood that includes: cholesterol, diabetes, prostate cancer (for men over 40), thyroid function (for women over 40), proper organ functioning, infection, and disease.

• Part 2 – Fitness assessment that includes: blood pressure, flexibility, height/weight, aerobic capacity (step test), body composition, strength (grip test) and lifestyle questionnaire.

• Part 3 – Counseling (the interpretation of test results and personal wellness profile; and suggestions for improvements). Employees that participate in the counseling will also receive their Participation in Agency’s Health Assessments Form at the session.

The agency-sponsored health assessments are performed by certified health care providers and the lab results are reviewed by a qualified physician. All results are confidential. All employees that complete the WO Wellness Program sponsored health assessments will receive a completed Participation in Agency’s Health Assessments Form (enclosure 1) from the WO Wellness Program contractor that serves as proof of participation.

Employees must complete the health assessments annually to participate in the physical fitness program and wellness reimbursements components of the WO Wellness Program.

An employee’s personal physician or health care provider can submit written approval for him/her to participate in physical fitness activities in lieu of the agency-sponsored health assessments. The wellness education component is open to all employees and is not subject to the health assessment requirement; however, we encourage all employees to complete the health assessments. Employees unavailable during the health assessments must have a letter from their health care provider at their own expense before participating in the physical fitness program or they may elect to wait until the next available health assessment. Employees will be not allowed to go directly to the vendor’s site for health assessments, if they are unavailable during the scheduled health assessments.

Employees in the high-risk category must have a letter from their health care provider (at their own expense) prior to beginning a physical fitness program (i.e., working out in a fitness center and/or using official time). Activities such as walking and stretching do not require the health care provider’s approval; however, it is up to the employee to discuss his or her fitness and/or wellness goals with his or her health care provider.

Enclosed is a sample letter (enclosure 2) that the employee can have the health care provider sign if a medical clearance is needed before participating in the physical fitness activities while on official time or if they are unavailable to participate in any of the agency-sponsored health assessments.

2. Physical Fitness Program. Employees are encouraged to participate in health and fitness activities and develop their personal wellness goals. To participate in the WO Wellness Program, all employees are required to complete the health assessments at least annually and/or if you are in the high-risk category and plan to use a fitness center or other structured facility during official time, you must also provide a statement from your health care provider (refer to health assessments). In addition to the Participation in

Agency’s Health Assessments Form provided to you by the WO Wellness Contractor, employees must complete a Personal Wellness Agreement (enclosure 3) that must be signed by the employee and supervisor. In the Personal Wellness Agreement, employees will state that they have completed the self-assessment and if they have any high-risk conditions they will also enclose a letter from their health care provider if they plan to use the physical fitness program component of the WO Wellness Plan. Supervisors should not approve the Personal Wellness Agreement for employees to use official time to exercise at a fitness center or other activities that might cause the employee harm, if the employee has indicated that they have a high-risk condition without a letter from the health care provider. After the supervisor approves the Personal Wellness Agreement, a copy must be sent to the WO Wellness Program Manager, Office of Safety and Occupational Health.

a) Approved activities. When participating in a physical fitness program, the Forest Service must identify sanctioned fitness activities that consider the potential for inquiries and the image such activities present to the public. Approved activities should involve cardiovascular and muscular endurance, strength activities, etc. The following are some activities that employees can participate in and may be considered when developing your Personal Wellness Agreement: running/jogging, walking, aerobics, weight machines, stationary bicycles, swimming (in a pool), stretching/toning, yoga, treadmill, stair/step machine, free weights, skipping/jumping rope, and non-contact martial arts. Employees can also participate in weight management, stress management, and smoking cessation classes and workshops.

b) Use of administrative leave. Employees participating in the WO Wellness Program may use up to 3 hours of administrative leave (06/66) to work out or for an approved wellness activity, if their workload permits. These hours must be used over a 3-day period during the week and inside of your official work hours. Employees can not use administrative leave in lieu of travel time for any activity. The official time used must fall within an employee’s prescribed tour of duty or flexible work schedule at times mutually agreeable between the employee and his/her supervisor. Employees must use increments of at least ½ hour NTE 1 hour per day (cannot split the hour each day); and may not exceed 3 hours per week. Unused hours can not be carried over to the next day or week. Before the employee uses this option, they must complete the following:

1) The Forest Service-sponsored health assessments and/or approval from your health care provider at your cost (see health assessments) if you are in the high-risk category. If you are unavailable to participate during one of the quarterly health assessments and you want to participate in the program before the next scheduled health assessment, you should also obtain approval from your health care provider at your expense.

2) The Personal Wellness Agreement that must be approved by both the employee and the supervisor and a copy must be sent to the WO Wellness Program Manager.

c) Liability. Employees injured while participating in agency-approved physical fitness activities, may file workers’ compensation claims with the Department of Labor if inquired while participating in an agency-sponsored physical fitness program (refer to Federal Employees Compensation Action, 5.U.S.C. 8108, et seq). When developing their Personal Wellness Agreement, employees should consider activities that limit the potential for injury or illness. Employees in the high-risk categories must seek approval from their health care provider before engaging in any activity while on official time.

3. Wellness Education. This component of the WO Wellness Program provide employees with information on an array of topics such as nutrition, stress management, weight management, smoking cessation, information on disease prevention, and other similar wellness issues. Employees are encouraged to participate in wellness education activities such as seminars/workshops, health fairs, and Federal Fitness Day events. If the workload permits, supervisors will authorize employee’s official time (code 01) who wish to participate in any WO Wellness Program-sponsored activity, as with any Forest Service meeting. Employees also receive monthly newsletters and publications and other wellness literature. Additional wellness information is located at the WO Wellness Program’s website at the at the Office of Safety and Health wellness website.

4. Wellness Reimbursements. Based on the availability of funds, the WO Wellness Program may offer reimbursements to employees for fitness center memberships-- USDA/ESRA fitness center or another Government or employee-sponsored fitness/exercise center, or commercial fitness/exercise center. To be eligible for reimbursements, you must complete the agency-sponsored health assessments or have a note from your health care provider at your expense and Personal Wellness Agreement (see health assessments and physical fitness programs.) You must be current member of the WO Wellness Program before you incur expenses. Here are some tips that should be helpful:

-- Based on availability of funds, the WO Wellness Program will reimburse eligible employees 1/2 of that they have paid NTE $150 per fiscal year. Eligible employees are employees that are current members of the WO Wellness Program. All claims for wellness reimbursements are to be submitted to this office by August 15.

-- Must have proof of payment such as the original itemized invoice or receipts for expense(s) with proof of payment. If you have payroll deductions for your wellness activities, most vendors (including the USDA Fitness Center); will provide you with proof of payment on their letterhead.

-- If you pay for your membership/wellness activities in advance, the Federal Government will not reimburse you in advance. The performance period must have been completed before you are reimbursed.

-- You must be a current member before you incur any expenses for reimbursement.

-- For additional information, refer to the Guidelines for Wellness Program Reimbursements (enclosure 4).

Funding

Based on availability of funds, the Forest Service will fund all wellness educational opportunities (seminar, health fairs, etc) and group health prevention activities (health assessments) sponsored or recognized through the WO Wellness Program.

Monitoring

The Forest Service is aware of the major benefits of a wellness program to both the organization and individuals that have been well established through research and application in other larger organizations. We do not intend to use resources to duplicate those findings on a local level. We will, however, continue to monitor the costs, participation, feedback, and accomplishments on how to improve our program.

Enclosures

Participation in Agency’s Health Assessments Form (Sample Only—the dates will be completed by WO Wellness Program contractor after you complete the health assessments, if applicable.)

(Enclosure 1)

1. Employee’s Name _________________________________________

2. Telephone Number _________________________________________

3. Staff _________________________________________

4. Completion Dates

a. Health Assessment _________________________________________

b. Fitness Assessment _________________________________________

c. Lifestyle Assessment _______________________________________

d. Individual Counseling _________________________________________

5. Recommended Activities

a. ______________________________________________________________

b. ______________________________________________________________

c. ______________________________________________________________

d. ______________________________________________________________

e. ______________________________________________________________

6. Comments __________________________________________________________

7. Certification that health assessments have been completed as stated in number 4.

WO Wellness Program Contractor Title Date

Physician or Health Care Provider’s Authorization (To be completed by Employee and Health Care Provider)

(Enclosure 2)

Section 1: To be completed by the employee 1/:

Your physician or health care provider’s authorization is required if you have indicated the presence of any of the following symptoms or conditions:

___ High blood pressure (above 140/90 at screening), ___ Cigarette smoking (within the past 5 years), ___ Family history of heart disease (parent, sister, or brother—age 50 or younger), ___ Diabetes Mellitus, ___ Have a sedentary lifestyle, ___ Bone or joint problems, ___ Symptoms of coronary heart disease, and ___ High-risk conditions not mentioned above.

Section 2: To be completed by the authorizing physician or health care provider 2/:

Physician’s Name: ___________________________________________

Telephone Number: ___________________________________________

____________________________ (Patient’s Name) may participate in an unsupervised fitness program offered through the Forest Service. Please specify any recommendations, limitations, or comments that the Forest Service (as administrators of this program) should be aware of:

Does this condition warrant reevaluation? If so, when? ___________________________

Physician’s Signature ______________________________ Date __________________

1/ The self-assessment tool is for your use. You do not need to share with your supervisor; however, if you check one or more items, you must have a letter from your doctor.

2/ Use of this form is optional. You may submit your own form (i.e., statement on a prescription pad) or use your own letterhead that states the employee may exercise.

You do not need to reveal the employee’s condition.)

Personal Wellness Agreement (To be completed by employee and supervisor)

(Enclosure 3)

I, _______________________________________, voluntarily agree to participate in the WO Wellness Program’s physical fitness program and/or wellness reimbursement components and will abide by all requirements of the WO Wellness Plan. I understand that personal responsibility is a large factor in successfully managing this program. I will choose activities from the approved sanctioned activities listed in the WO Wellness Plan.

Notice: If the employee and supervisor agree to this agreement, it is the employee’s responsibility to provide a copy to the WO Wellness Program Manager.

My activity(s) will be as followed (describe):

1. _____________________________________________________________________

2. _____________________________________________________________________

3. ____________________________________________________________________

My health objectives are:

1. _____________________________________________________________________

2. _____________________________________________________________________

3. _____________________________________________________________________

My wellness activities will be performed during the following three (3) workdays (Monday-Friday) and hours. For example, Day 1: Monday – 0700-0800; Day 2:

Wednesday – 1100-1200; and Day 3: Friday – 1530-1630. Employees and supervisors must agree on any deviations from this schedule.

Day 1: _________________________________________________________________

Day 2: _________________________________________________________________

Day 3: _________________________________________________________________

Known health risks:

I have completed the agency-sponsored health assessments, and do not have any known health risks. ___Yes ___No

I do have known health risks, and have enclosed a letter from my health care provider stating that I may participate in physical fitness activities.

___Yes ___No

If at any time during the agreement that I develop any health risks, I agree to discontinue the physical fitness portion of the program until I receive a letter from my health care provider at my expense. ___Yes ___No

Further, I understand that:

• It is my overall responsibility to consult with a physician or health care provider before starting any physical fitness program activity.

• The WO Wellness Program and its representatives assume no liability for any illness or injury associated with the WO Wellness Plan activities.

• I will follow the guidelines of the program by keeping all of my paperwork up to date on an annual basis, if I plan to continue in the program. A copy of all documents must be provided to the WO Wellness Program Manager.

• If my paperwork is not keep current on an annual basis, I understand that I must refrain from using the excused leave and/or wellness reimbursement options of the WO Wellness Program and I am no longer a member.

Signatures/Approvals:

Employee’s Signature* Date

Approved: _________

Disapproved: ________ If disapproved, state reasons: __________________________

Supervisor’s Signature* Date

This agreement will expire on: *___________________________; 1 year from the date of your last health assessment or doctor’s note. Any deviations to this agreement must be approved in advance by the supervisor. If you are no longer participating in the administrative leave option of the physical fitness program, notify your supervisor either verbally or in writing (email message is sufficient).

Employee’s responsibility to distribute copies of Personal Wellness Agreement (after all the required signatures/approvals) to:

1. Employee Original

2. Supervisor Copy

3. Wellness Program Manager Copy

GUIDELINES FOR

WELLNESS PROGRAM REIMBURSEMENTS

(Enclosure 4)

The Forest Service reimburses full-time WO metro area employees 50 percent of the total cost spent NTE $150 per fiscal year based on the availability of funds. To reimbursed, all employees must be part of the WO Wellness Program.

Wellness Reimbursements: As of June 1, 2016, all FS employee reimbursements must be processed using the modernized eForm FS-6500-229. Because we have a wellness budget for the employees geographically located in the WO that are covered by the WO wellness plan, the WO Wellness Program Manager will continue to manage the WO Wellness budget. Some things to keep in mind are listed below; however, if you have any questions on your eligibility, please contact the WO Wellness Program Manager.

Quick Tips:

1. Must be a current member of the program before expenses are incurred.

2. You can only claim expenses that you have actually paid for and used while you were a current member of the program.

3. Before you complete your claim, send an email to the WO Wellness Program

Manager with the estimated amount of your claim.

4. We will send you an email with our job code to use one-time only and you will not be authorized to share with others. They must follow the same process.

5. The required eForm FS-6500-229 can be located on the ASC B&F Miscellaneous

Payments website.

6. For the signature, add the WO Wellness Program Manager as your supervisor.

7. Enter the exact period that you are claiming (see the ASC example).

8. Enter the exact amount on your form that you are claiming.

9. On the form, attach all of the necessary paperwork such as receipts (in your name), complete personal wellness agreement(s), etc.

10. All forms must be sent to us by August 15.

11. All forms must be 100 percent accurate.

Some of the approved activities eligible for reimbursement are:

1. Health and fitness club memberships (i.e., USDA/ESRA Fitness Center, Bally’s, Gold's Gym). It also includes memberships to Weight Watchers, Jenny Craig, and other weight management programs. (Note: The cost of food, exercise clothes, and equipment are not reimbursable expenses under the WO Wellness Program.)

2. Nicotine Replacement Therapy (as part of the Smoking Cessation Program); items such as nicotine replacement gum and patches.

3. Martial arts (non-contact), aerobics, swimming (in a pool), and other structured health maintenance activities or programs that require exertion.

http://fsweb.asc.fs.fed.us/bfm/programs/financial-operations/payments/miscellaneous/index.php http://fsweb.asc.fs.fed.us/bfm/programs/financial-operations/payments/miscellaneous/index.php http://fsweb.asc.fs.fed.us/bfm/programs/financial-operations/payments/miscellaneous/index.php http://fsweb.asc.fs.fed.us/bfm/programs/financial-operations/payments/miscellaneous/index.php

Frequently Asked Questions for Employees Geographically Located in the WO

(Enclosure 5) (In development, but will be updated soon.)

Program Management

Excused Leave

Wellness Reimbursements

Miscellaneous

If you have any questions, please contact TBD or via e-mail TBD

Thanks for participating in the WO Wellness Program!

mailto:wveney@fs.fed.us mailto:wveney@fs.fed.us

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52.212-4 CONTRACT TERMS AND CONDITIONS -- COMMERCIAL ITEMS

(OCT 2018)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights-

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include --

(i) Name and address of the Contractor;

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(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer— System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payments. - (1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt Payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C.3903) and prompt payment regulations at 5 CFR Part1315.

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(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment,…