FInal SOW_Dental Contract.docx

STATEMENT OF WORK

DEFINITIONS

1. VISN 7: Veterans Integrated Service network consisting of the VA Medical Centers located in the states of Alabama, Georgia and South Carolina

2. VAMC: Veterans Affairs Medical Center

3. Special Handling: Unusual circumstances may dictate the need for a dental order to be picked up specially, specially shipped and returned overnight, or processed within a shorter time frame, pick ups must be daily for normal cases.

4. Routine Handling: A dental laboratory work authorization that is usually performed and returned within a specified time frame, generally 2 -15 days, the length of elapsed time between pickup of the dental lab order by the contractor until the receipt of the complete order by VA Dental Service.

5. Using Service: Birmingham, AL VA Healthcare System

6. COR: Contracting Officer’s Representative.

7. Dental Laboratory Services: Laboratory procedures are required for the treatment of dental patients. These would include, but not be limited to, all laboratory fabrication aspects of complete dentures, removable partial dentures, fixed partial dentures and crowns, and dental implant prostheses.

8. Working Day: Any twenty-four-hour period of the typical administrative work week, i.e. Monday through Friday (M-F). For example, if the contractor is allowed 5 working days for a prosthesis and he picks it up on a Monday, it would be due back to VA the following Monday. Federal holidays occurring M-F are not considered a working day.

9. Turn Around Time (TAT): The length of elapsed time between pickup of the dental lab order by the contractor until the receipt of the complete order by VA Dental Service.

TERMS OF CONTRACT

This contract is effective for the period of 5 years to include a base and 4 one-year option renewals.

GENERAL REQUIREMENTS

The contractor shall furnish Monday through Friday between the hours of 7:30 a.m. and 4:00 p.m. local time, all labor, transportation, materials, equipment and supervision required to provide Dental Prostheses to the VA Medical Center Dental Services, 700 South 19th Street, Birmingham, AL 35233.

1. The Contractor shall fabricate dental prosthetic items in strict accordance with the dental laboratory order for the fabrication of dental prostheses, which shall include but not be limited to the following; all laboratory fabrication aspects of complete dentures, removable partial dentures, fixed partial dentures and crowns, and dental implant prostheses.

2. Special handling may be required on specific orders and will be authorized on a case by case basis by the VAMC and paid for under a separate purchase order.

3. The contractor shall be located within a 2-hour drive time radius, in order to accommodate the 2 - 15 DAY turnaround time for services.

4. The normal turnaround time (in working days as defined) for dental prosthetic items shall be:

a. Two Days:

1. Complete and Removable Partial Denture acrylic resin repairs

2. Complete and Removable Partial Denture, tooth additions/repairs

3. Complete and Removable Partial Denture Relines/Rebases

4. Custom impression trays

5. Poured Impressions & master cast fabrication

6. Articulation of cast

7. Cast duplications

8. Cast Post and Cores

9. Solder/Laser Weld

10. Record Bases & Occlusal Rims

b. Three Working Days:

1. Full Cast Crowns

2. Complete and Removable Partial Dentures (RPD), tooth setup

3. Complete and Removable Partial Denture, Process and Finish

4. Flexible Partial Denture, Process and Finish

c. Four Working Days:

1. Flexible Partial denture, tooth set-up

2. Resetting teeth, denture or RPD

d. Five Working Days:

1. 1-10 Crown and Bridge Units, (PFM, Zirconia, All ceramic)

2. BruxZir or IPS e.max crown or bridge

3. Cast Partial Denture Framework

4. Removable Partial Denture Set-up, Process, and Finish

5. Complete Denture Set-up, Process, and Finish

6. Removable Partial Denture Clasp Repairs or Additions

7. Comfort hard/soft mouth guards

8. Processed, milled, or printed implant surgical Guides

9. Implant Bars

10. Transitional Partial Denture Setup and Process

11. Diagnostic Wax-up,

e. Six Working Days:

1. Flexible Partial Denture Setup, Process, and Finish

f. Seven Working Days:

1. Eleven or more Crown and Bridge Units, (PFM, Zirconia, All ceramic)

2. Orthodontic Appliances

3. Crown with attachment

g. Eight Working Days:

1. Procera Crown

2. Custom titanium or zirconium abutments only

3. Obturators

h. Ten Working Days:

1. One to twelve units in Select Department

2. RPD frameworks with incorporated occlusion

i. Fifteen Working Days

1. Custom titanium or zirconium abutments with crowns

5. The following materials shall be used in the fabrication of dental prostheses

a. Complete Dentures/Removable Partial Dentures:

Lucitone 199 acrylic resin or equivalent Coelor coloration or equivalent Occlusal Scheme:

Monoplane, linear Anatomic, full balanced Lingualized, linear 33 */monoplane 30 *rational Functional/rational Tooth material:

Trybyte ™IPN(Dentsply) or equivalent Ivoclar Blueline Heraus Kulzer

b. Fixed Partial Denture/Crown:

High Noble-- All crown and bridge metal must be high noble alloy—by ADA definition at least 60% noble metal of which at least 40% must be gold

c. Implant Systems:

Nobel Biocare BioHorizons/Zimmer Astra Biomet 3I Straumann

6. Contractor shall provide the following services at the VA Dental Service:

a. Forms for the authorization of work at their facility.

b. Once daily pick-up and delivery Monday through Friday in the Dental Clinic, to include but not limited to:

1. All impressions

2. All cast, articulators etc. necessary for the proper and timely dental treatment of all patients

7. Contractor shall consult with the appropriate Using Service at the VAMC regarding any specific dental laboratory order.

8. Guarantee complete satisfaction with workmanship and materials of the prosthesis. If the appliance is unacceptable the item will be remade/adjusted at no charge. This warranty would not extend against normal wear and tear, accidental breakage or negligence.

9. The contractor will process all case submissions for fixed, removable, and implant prosthetics in house

10. The prime contractor will be an established dental lab that can be verified as such. All subcontractors will be utilized IAW the solicitation.

QUALITY OF WORK

Communication back and forth between the VA and the Vendor is important to maintain and coordinate the quality assurance aspects of this contract.

1. The contractor will follow the quality guidelines as outlined in the Quality Assurance Surveillance Plan (QASP), as included in subsequent contract award.

2. Failed Standard; Validated complaints/year that exceed 2% as determined by the contracting officer or contracting officer representative. If the contractor fails to meet this standard it may be cause for contract termination or corrective action.

3. Remakes: If it is found that any laboratory items are not compliant with the QASP of the Dental Laboratory procedures, the contractor shall remake the item at no additional cost.

4. The COR will notify the vendor in writing on a monthly basis any issues concerning quality complaints of dental laboratory items providing detailed information for the vendor to correct identified discrepancies.

QUALITY ASSESSMENT GUIDELINES

I. Complete and Partial Dentures

1. Denture and partial denture impression must be boxed and poured in improved stone and be dense and free from voids. Denture and partial cast must have a peripheral roll on the cast such that the border molding has been maintained. The roll should be 2-3 mm in height, and the land area should also be 2-3 mm wide for the border molded area.

2. Denture acrylic must be free from porosity and highly polished. Ethnic acrylic shades must be available for use and ethic shade guides must be provided to the VA lab to help in selecting the proper acrylic shade for the patient. Borders must be maintained when processing and finishing prostheses. There should be no attempt to fit processed denture or partial denture bases back to the master cast.

Acrylic around denture teeth shall be anatomically correct and maintained after polishing with a minimal amount of flash acrylic on denture teeth.

3. Lab must be able to set different types of occlusal schemes as requested to include:

a. Cross tooth cross arch balanced occlusal scheme

b. Lingualized occlusal scheme

c. Lingualized non-balanced occlusal scheme

d. Monoplane/neutrocentric occlusal scheme

REF-1. Dental Laboratory Procedures---Morrow, Rudd and Eissmann

2. U.S. Air Force Lab Manual—AFPAM-103VI

4. All denture and partial denture cases shall be remounted before separating from the master cast to insure pin opening from processing is less than 1mm and also to correct any occlusal discrepancy. For cases with pin opening greater than 1 mm they must be adjusted at the lab. VA lab has the right to reject denture and partial denture cases whose teeth have been excessively adjusted and no longer resemble teeth.

5. All partial denture cast frameworks shall be returned on the master cast. The master cast shall not be abraded in any way. All rests must be completely seated within 75-100 microns and fit the full extent of the prepared rest seat. All frameworks must be smoothly polished and free from porosity. A nickel free alloy must be used in fabrication of metal partial denture frameworks.

6. All laboratory prescriptions done by VA dentists must be exactly followed. If a deviation from the requested design is required, the contract lab must request authorization from VA dentist.

7. Lab must provide and assortment of denture teeth that are available for use. Only the highest quality denture teeth shall be used in all prostheses.

8. All removable prostheses must have the patients’ last name placed in the acrylic.

9. Removable cases mounted at the contract lab will be mounted on a calibrated whip mix 2240 articulator.

10. Excessive block-out shall not be used on record bases and every attempt shall be made to maintain the same peripheral border on the master cast in the record bases.

II. Crown and Bridge and Implant Prostheses

1. Microscopes must be used to evaluate all crowns and bridges and must fit the dies or implant custom abutments (within 75 microns). There shall be no ledges. The VA shall return any prostheses that do not meet these standards for repair or remake at contract lab expense.

2. All metal used for metal ceramic and gold crowns will be high noble. (ADA specifications for high noble-60% high noble metal of which 40% must be gold).

The only time a base metal may be used is for resin retained fixed partial dentures (Maryland Bridges) or cast post and cores as requested. There will be no holes in metal copings on which porcelain has been applied.

3. All crowns and bridges should be anatomically correct with proper emergence profile and not over-contoured unless specified on the laboratory prescription.

4. All porcelain must be dense with no porosity and match precisely the requested shade tab, photograph and/or lab prescription custom design. No metal or opaque can be showing through areas where porcelain is supposed to be applied. All frameworks supporting the porcelain shall support the veneering porcelain such that there must be no more than 2 mm of unsupported veneering porcelain. VA lab must be able to add contact and occlusion if necessary to the applied porcelain. Contract lab will provide firing cycle numbers and sample material necessary to make chair-side corrections of the porcelain. If porcelain cracks/fractures with-in 1 year of insertion, contract laboratory will remake prosthesis at no cost to VA.

5. All cases should hold shim-stock when articulated. Occlusal contacts shall be on proper cusp, fossa and marginal ridges where possible. There shall be contact only in centric occlusion and not in lateral movements except where requested.

6. Cases mounted by contract lab will be mounted on a calibrated 2240 whip mix articulator.

7. No plastic articulators will be used for dual arch impressions. All cases must be mounted on a metal articulator.

8. Implant custom abutments must be fabricated according to the dentist specifications. Soft tissue cast must be utilized and no cement retained restoration margin should ever be more than 1 mm below the tissue.

9. All crowns and bridges must be fit to a solid cast to provide the most accurate proximal contacts.

10. Contract lab must be able to accept digital impressions.

SPECIAL REQUIREMENTS

1. The contractor shall notify the contracting officer of any proposed changes in subcontracted dental laboratories and have prior written approval (by the contracting officer) before any changes are implemented. The contractor agrees to absorb any increase in charges as a result of any changes in subcontracted laboratories.

2. Quality Control: Dental Laboratory procedures and products will be assessed by the COR by using the QASP of Dental Laboratory procedures. Contractor shall provide with upon request a detailed description of quality control procedures. Contractor shall provide with upon request a detailed description of quality control policies and procedures followed by the contractor in the fabrication of dental prostheses.

3. The contractor will provide the following, upon request, as well as provide copies during the term of the contract to the CO and COR upon request.

a. A mutually agreeable time for pickup and delivery.

b. Telephone numbers and contact persons to be used by the using service at the VAMC to inquire about specific dental laboratory orders.

c. A narrative description of the laboratory’s quality control program.

4. The contractor shall maintain acceptable services, reporting systems and quality controls as specified herein. Failure to comply with the specified terms and conditions and/or failure to perform satisfactorily may be grounds for pursuing termination of the contract.

METHOD OF PAYMENT

Payment will be made by each participating medical facility either via electronic funds transfer or purchase order. Each facility will coordinate the method of payment with the awarded vendor(s).