Approved PWS Annual OSHA Surveillance Exams.pdf

Performance Work Statement (PWS)

For

Occupational Health Examination Services

Published by:

South Carolina National Guard

Occupational Health Office

Joint Forces Reserve Center (JFRC)

860 South Carolina Road, Eastover, SC 29044-5052

Original Approved Publication Date: 22 February 2022

Table of Contents

1.0 General

2.0 Definitions and Acronyms

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S)

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E)

5.0 Requirements

6.0 Applicable Publications

Technical Exhibit 1 - Performance Requirements Summary (PRS)

Technical Exhibit 2 - Deliverables Schedule

Technical Exhibit 3 - Historical Workload Data

Technical Exhibit 4 - Estimated Workload Data for All Period of Performances

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Occupational Health Examination Services, as defined in this PWS.

1.2 Background: The purpose of the Occupational Medical Surveillance Examination Program is to provide job-related Occupational Health Examinations and Medical Surveillance Services to the SCARNG full-time support (FTS) and/or temporary personnel who are exposed to OSHA level PEL health hazards in the work environment. The examination shall include personnel assigned to positions requiring specific standards of physical fitness. Personnel not included under these examinations are State Employees, civilian contractors, Active Guard Reserve, Active Duty for Operational Support (ADOS) and part-time traditional Soldiers.

1.3 Period of Performance (PoP): The Period of Performance shall be one Base Year of 8 months, four 12-month option periods and a 6 month option in accordance with (IAW) FAR

Clause 52.217-8 Option to Extend Services. Note, based on the actual award date, the POP may need to be adjusted slightly.

Base Year 15 Apr 2022 – 31 Dec 2022

Option Year 1 01 Jan 2023 – 31 Dec 2023

Option Year 2 01 Jan 2024 – 31 Dec 2024 (Leap Year)

Option Year 3 01 Jan 2025 – 31 Dec 2025

Option Year 4 01 Jan 2026 – 31 Dec 2026

6 Month Option 01 Jan 2027 – 29 Jun 2027

1.4 General Information:

1.4.1 Place and Performance of Services: The contractor shall provide services between the hours of 0730 – 1700, Monday - Thursday, except on recognized US holidays or when the

Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Performance shall be at

Armed Forces Readiness Center (AFRC), McEntire Joint National Guard Base, 860 South

Carolina Road, Eastover, South Carolina 29044. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential. The on Government site services will occur over a consecutive two week period that will occur during the period of performance at a date coordinated between the Contracting

Officer Representative (COR) and the contractor, with priority to Government need. Be advised the two week period is subject to change due to mission changes such as state or federal missions/emergencies.

1.4.1.1 Telework:

The Government does not authorize telework in support of this requirement. However, if deemed necessary, in furtherance of Continuity of Operations Planning (COOP), a telework program may be enacted to ensure that the Government's mission-critical operations stay operational during times of national emergency or incidents of national significance. Telework shall be at no additional cost to the Government.

1.4.1.2 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.1.3 The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation.

Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times, and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders of the installation, which may affect performance.

The Government reserves the right to direct the removal of an employee from Government property or revoke access to Government systems for misconduct, security reasons, or any overt evidence of communicable disease. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

1.4.2 Recognized Holidays: The following are recognized United States (US) holidays. The contractor shall not perform services on these days:

1.4.2.1 New Year’s Day: January 1st

1.4.2.2 Martin Luther King, Jr.’s Birthday

1.4.2.3 President’s Day

1.4.2.4 Memorial Day

1.4.2.5 Juneteenth National Independence Day: June 19th

1.4.2.6 Independence Day: July 4th

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.9 Veteran’s Day: November 11th

1.4.2.10 Thanksgiving Day

1.4.2.11 Christmas Day: December 25th

1.4.3 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan

(QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary

(PRS). A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after contract award. After acceptance of the QCP, the contractor shall obtain the

Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

1.4.4 Quality Assurance (QA): The Government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government will do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) or defect rate(s).

1.4.5 Installation Access and Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services, or

Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DoD), Headquarters Department of Army

(HQDA) and/or local policy (see PWS 6.0). Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.5.1 Reserved.

1.4.5.2 For contractors that do not require a CAC, but require access to a DoD facility or installation: Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate

Identification (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05), and applicable installation, facility and area commander installation/facility access, and local security policies and procedures (provided by a Government representative).

1.4.5.3 Awareness Training (AT) Level 1: All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete AT Level 1 training within 15 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee to the COR within 15 calendar days after completion of training by each employee or subcontractor personnel. AT Level 1 awareness training is available at the following website:

https://jko.jten.mil/courses/atl1/launch.html.

1.4.5.4 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program (training standards provided by the requiring activity Antiterrorism

Officer (ATO)). This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO.

This training shall be completed within 15 calendar days of contract award and within 15 calendar days of new employees commencing performance. The contractor shall report https://jko.jten.mil/courses/atl1/launch.html completion for each contractor employee and subcontractor employee to the COR within 15 calendar days after completion of training.

1.4.5.5 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to COMSEC review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DoD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DoD organizations.

Therefore, the contractor is advised that any time contractor personnel place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DoD information. The contractor shall abide by all Government regulations concerning the authorized use of the

Government's computer network, including the restriction against using the network to recruit

Government personnel or advertise job openings.

1.4.5.6 Reserved.

1.4.5.7 Reserved.

1.4.5.8 Reserved.

1.4.5.9 Reserved.

1.4.5.10 Protection of Personally Identifiable Information (PII). The contractor shall protect all

PII encountered in the performance of services in accordance with Defense Federal Acquisition

Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD

5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

1.4.5.11 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 15 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training. Level 1

OPSEC training is available at https://securityawareness.usalearning.gov/opsec/index.htm.

1.4.5.12 Reserved.

1.4.5.13 Reserved.

1.4.5.14 Reserved.

1.4.6 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

1.4.6.1 Reserved.

1.4.6.2 Reserved.

1.4.7 Special Qualifications: Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified, and otherwise qualified to provide services.

1.4.7.1 Contractor shall ensure all procedures are conducted in accordance with applicable

American Board of Occupational and Environmental Medicine (ABOEM), American

Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, Occupational

Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) Standards.

1.4.7.2 Contractor shall ensure all clinical laboratory services are performed by a laboratory licensed through the U.S. Department of Health and Human Services (DHHS), Health Care

Financing Administration pursuant to the terms of the Clinical Laboratories Improvement Act of

1967 (42 U.S.C. 263a) and the College of American Pathologies.

1.4.7.3 Contractor shall provide a Board eligible or Certified Occupational Medicine Physician to conduct job-related medical surveillance physical examinations and occupational health specialty examinations.

1.4.7.4 Contractor shall ensure Pulmonary Function Tests (PFTs) Performed by a licensed physician, Certified Pulmonary Function Technologist, or Registered Respiratory Therapist in accordance with 29 CFR 1910.1001.

1.4.8 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically (e.g. daily during testing) with the contractor to review the contactor’s performance and make any necessary adjustments prior to next days examinations. At these meetings, the KO will apprise the contractor of how the

Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the

Government.

1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR, to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities. Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed.

1.4.10.1 The contractor shall retrieve all identification media (including vehicle passes) from its employees who depart employment for any reason. The contractor shall return all identification media (i.e., badges and vehicles passes) to the KO within 14 days of an employee’s departure.

1.4.11. Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract;

procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United

States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.

1.4.12 Reserved.

1.4.13 Data Rights: The Government has unlimited rights to all documents/materials produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government.

These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.4.14 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the

KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.4.15 Reserved.

(End of paragraph 1.0)

2.0 Definitions and Acronyms:

2.1 Definitions:

2.1.1 Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the Government. The term used in this contract refers to the prime.

2.1.2 Defective Service: A service output that does not meet the standard of performance associated with the PWS.

2.1.3 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.4 Key Personnel: Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.5 Physical Security: Actions that prevent the loss or damage of Government property.

2.1.6 Quality Assurance: The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.7 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.8 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements.

2.1.9 Subcontractor: One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.2 Acronyms:

AEI Army Enterprise Infostructure

AR Army Regulation

AT/OPSEC Antiterrorism/Operational Security

BI Background Investigation

CM Contract Manager

COR Contracting Officer Representative

DA Department of the Army

DAG Deputy Adjutant General

DD254 Department of Defense Contract Security Classification Specification

DFARS Defense Federal Acquisition Regulation Supplement

DoD Department of Defense

DSCA Defense Counterintelligence and Security Agency

FAR Federal Acquisition Regulation

GFP/M/E/S Government Furnished Property/Material/Equipment/Services

HQDA Headquarters, Department of the Army

HSPD Homeland Security Presidential Directive

IDT Inactive Duty Training

IA Information Assurance

IS Information System(s)

KO Contracting Officer

MURC Multiple Unit Readiness Center

MUTA Multiple Unit Training Assembly

NGB National Guard Bureau

OCI Organizational Conflict of Interest

PII Personally Identifiable Information

PIPO Phase In/Phase Out

POC Point of Contact

PRS Performance Requirements Summary

PWS Performance Work Statement

QA Quality Assurance

QASP Quality Assurance Surveillance Plan

QC Quality Control

QCP Quality Control Program

SCR Service Contract Reporting

SSN Social Security Number

TAG The Adjutant General

TE Technical Exhibit

USD(I) Under Secretary of Defense for Intelligence

(End of paragraph 2.0)

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S): The

Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1 Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include desk space, chairs, and tables.

3.2 Reserved.

3.3 Reserved..

3.4 Reserved.

3.5 Utilities: All utilities in the facility will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.

(End of paragraph 3.0)

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph

3.0, the contractor shall furnish everything required to perform these services as indicated in

Paragraph 1.1.

4.2 Reserved.

4.3 Reserved.

(End of paragraph 4.0)

5.0 Requirements:

5.1 The contractor shall have onsite at all times a Contract Manager who can manage and provide oversight to ensure the services are being performed efficiently and in accordance with this PWS, terms and conditions of the contract.

5.2 Contractor shall perform a comprehensive review and evaluation within 30-days following the conclusion of testing. The Contracting Officer’s Representative (COR) will contact and schedule a follow-up review and evaluation meeting to discuss positive and negative aspects of testing.

5.3 Contractor shall provide copies of proposed reports utilized during this service to the COR 30 calendar's prior to first event for the COR to review to ensure adequacy.

5.4 The contractor shall provide the following medical services:

5.4.1 Contractor will provide a Job Functional Analysis or Kraus-Weber that includes back strength and flexibility if requested. Note any pain or recommended lifting limitations if less than 50 lbs.

5.4.1.1 Contractor shall conduct screenings on employees designated by the OHN to include all those exposed to respiratory hazards that will require a respirator to mitigate hazards identified as above the action level.

5.4.3 Contractor shall ensure test will include as a minimum Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), comparison with recognized normal’ s for the individual's height and weight, sex, race, age and a documented interpretation by a pulmonologist or certified Occupational Health physician.

5.4.3.1 Contractor shall follow NIOSH and ATS-ERS standard requirements:

5.4.3.2 Contractor shall continue testing individual when the patient is improving until improvement is <30ml.

5.4.3.3 Contractor shall ensure test results are acceptable with a minimum of three acceptable maneuvers that are free from a leak, obstructed mouthpiece, hesitation, false starts, cough, glottis closure, early termination, and have a good curve of at least 6 seconds duration.

5.4.3.4 Contractor shall ensure test results are reproducible in that they have the same result from the individual (two largest FVCs are within 0.150 L of each other and two largest FEV1's are within 0.150 L of each other) when the test is repeated several times. Testing is continued until criteria are met or 8 trials are attempted, or the employee being tested cannot or should not continue.

5.4.3.5 Contractor shall ensure if three (3) acceptable and two (2) repeatable tests cannot be obtained, the technician performing the PFT must document the reason the standard could not be met.

5.4.3.6 Contractor shall always use measured height not reported height by the nearest half inch without footwear.

5.4.3.7 Contractor shall always indicate source of reference value on reports for adjusted predicted value

5.4.3.8 Contractor shall ensure Government employee has not smoked within 1 hour prior to testing.

5.4.3.9 Contractor shall ensure that Government employee has had no cold, flu or allergies within two weeks

5.4.3.10 Contractor shall ensure that Government employee has not utilized an inhaler prior to test that would still be in the patient’s system.

5.4.4 Contractor shall ensure specifications regarding equipment guidelines and calibration, test administration, and test interpretation must meet applicable OSHA and ANSI standards.

Supporting documentation shall be provided to this office daily or annually depending on manufacturing guidelines of spirometer.

5.4.5 Contractor shall provide respirator clearance documentation and also give a copy to the employee at time of visit.

5.4.6 Contractor shall ensure that vision screenings are in accordance with DA PAM 40-506 using multiphasic vision screening equipment to measure the following primary visual skills and will be documented on contractors form approved by the COR.

5.4.6.1 Visual acuity for distance and near.

5.4.6.2 Lateral phorias for distance and near.

5.4.6.3 Vertical phorias for distance and near.

5.4.6.4 Depth perception.

5.4.6.5 Color perception.

5.4.6.6 Peripheral vision.

5.4.7 Contractor shall ensure laboratory tests will be processed by certified clinical laboratories and performed by personnel certified under the American Society of Clinical Pathology. The supporting laboratory will provide employee instruction and equipment necessary for tests requiring special collection methods and/or containers. Document that employee has been counseled by examining provider about laboratory test results. The contractor shall provide a copy of lab results to employee for their primary care physician.

5.4.8 Contractor shall ensure a review of physical examinations must be performed by a physician with emphasis on areas most likely to be affected by the employee's occupational exposures or desired certification.

5.4.9 Contractor shall ensure instrumentation must meet or exceed appropriate performance standards, and accuracy must be verified in accordance with current Occupational Medicine

Certification standards.

5.5 PERSONAL PROTECTIVE EQUIPMENT (PPE)

5.5.1 Contractor shall furnish and assure healthcare workers are provided with the appropriate

PPE such as, but not limited to: gloves, protective eyewear, and etc., where there is a potential for exposure to blood or other potentially infectious materials.

5.5.2 Contractor shall ensure each healthcare worker complies with the requirements of 29 CFR

1910.1030 Blood borne Pathogens Standard.

5.6 INFECTIOUS WASTE DISPOSAL

5.6.1 Contractor shall dispose of all infectious waste shall be in accordance with local, state, and federal regulation and disposed of by the contractor unless other accommodations have been coordinated in writing.

5.6.2 Contractor shall ensure puncture resistant sharps containers are readily accessible to healthcare workers and located in all treatment areas where sharps could potentially be used.

5.7 MEDICAL REPORTS AND RECORDKEEPING

5.7.1 Contractors shall immediately contact the Occupational Health Nurse by telephone at 803-

299-1634 if results of medical surveillance screening(s), which are questionable and / or of critical significance and / or require follow-up. Contractor shall ensure that all results to include all diagnostic tests, graphs, charts, reports, questionnaires, waivers, employee consent forms, physical findings, and examination results are made available to the Occupational Health Nurse within 30 working days of completion of testing. Any electronic access to records must be in printable format suitable to be filed in the employee’s medical record. Mailed documentation will be sent to the address listed below and the contractor is responsible for all postage fees.

5.7.2 Contractor shall identify all medical records with the employee’s full name, social security number, date of birth, job code, and the name of the employee’s work place or facility at a minimum. The contractor shall ensure work / health history forms and medical reports are complete and legible (typed / printed).

5.7.3 Contractor shall ensure that each employee signs the Privacy Act Statement (DD Form

2005) during the registration process.

5.8 SUMMARY REPORT:

The Contractor will provide a comprehensive report as follows:

Reports will be provided every six months directly to shops that were supported. Addresses and a point of contact for each shop will be provided. Each report will include a summary of shops employees by name and the date and type of physical(s) performed and indicate qualified or not qualified for each type and expiration. Documentation of these qualifications with expirations will be provided as a certification card for each worker examined and copies of these cards will be included in the report. All information contained within the report must be sufficient for the supervisor to refer to during an inspection without violating HIPAA. A duplicate report will be sent to the Occupational Health Nurse via electronic format.

5.9 EXAMINATION SCHEDULING

5.9.1 Coordination of scheduling shall be a joint effort between the COR and the Contractor, a draft copy of the scheduled will be initiated by the COR and sent to the Contractor for review and any needed adjustments. Contractor will provide the Occupational Health Nurse the estimated time needed for each employee based on physical components required to ensure efficient use of scheduled time. Scheduling of employees to be examined at clinic location will be accommodated by the Contractor within 30 days for routine visits and 7 days for urgent.

5.9.2 In the event of a Contractor equipment failure, specific testing and / or parts of examinations that are not completed during the testing period shall be completed at a scheduled time mutually convenient for the Contractor, Occupational Health Nurse and the Shops.

Unfinished testing / examinations will be completed at no additional cost to the Government.

The option to schedule physicals not completed due to equipment failure, through a local occupational medical facility shall be done at no cost to the Government. The Contractor shall be directly responsible to cover costs for completing these make-up screenings.

5.10 INVOICE: The contractor will upload an invoice, for all services performed under this contract, to the Wide Area Workflow (WAWF) module within the Procurement Integrated

Enterprise Environment (PIEE) at https://piee.eb.mil/

5.11 DESCRIPTION OF SERVICES

Examinations are determined based upon job codes and identified occupational hazard exposure.

The following standard laboratory services are to be provided under this PWS:

5.11.1 Lab Services-Frequently Used Labs Units Schedule Unit

a. Occ Health Profile (Bundle: CBC, liver function test, BUN, Creatinine, Urinalysis) Each

b. CBC (HGB, HCT, WBC, MCV, MCH, MCHC) with diff Each

c. CBC (HGB, HCT, WBC, MCV, MCH, MCHC) without diff Each

d. Liver Function Test (AST, ALT, ALB, ALK PHOS, dBil, TBil, Protein) Each

e. BUN /Creatinine Each

f. Urinalysis with Micro Each

g. Urinalysis without Micro Each

h. Blood Glucose Each

5.11.2 Infrequently Used Labs Units Schedule Unit Price

a. Cadmium Profile (Per Lab Corp)

b. Human Chorionic Gonadotropin HCG beta

c. Chromium (Blood)

d. Lead, industrial whole blood

e. ZPP, Blood Protoporphyrins, zinc

5.11.3 Procedures

a. Audiometry

b. B-Reading

c. Chest X-Ray (PA & Lat View)

d. Spirometry

e. Comprehensive Vision

f. Vital Signs / Body Ht and Wt. (no charge with exam) Each

g. Venipuncture and Specimen Handling Each

5.11.4 Exams Units Schedule Unit Price

a. Comprehensive Exam (Medical Surveillance)

b. Billing Terms

c. OHC Terms Units Schedule Unit Price

d. Record Processing services as related to Exams or Clearances

e. Record Processing (Mailing of X-rays)

f. Missed Work-up or missed procedure

g. Missed Exam

5.12 Contractor Employee COVID-19 Guidance. Contractor shall ensure that all contract employees, prime or subcontract, are following the latest guidance published by the Safer

Federal Workforce Task Force Guidance at https://www.saferfederalworkforce.gov/ IAW DoD

Class Deviation 2021-O0009.

5.10. Privacy Act and Health Insurance Portability and Accountability Act (HIPPA). The contractor shall require all contractor and subcontractor employees to complete HIPPA training who are scheduled to work the event. The contractor shall provide copies of each employee's training certificate NLT 15 days prior to the schedule event.

(End of paragraph 5.0) https://www.saferfederalworkforce.gov/

6.0 Applicable Publications: Publications applicable to this PWS are listed below:

Publication

(Chapter/Page)

Date of

Publication

Mandator y or

Advisory

Website

Federal Acquisition Regulation https://www.acquisition.gov/?q=browsefar

Defense Federal Acquisition

Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/curr ent/index.html or https://www.acquisition.gov/dfars

Joint Travel Regulation (JTR) https://www.defensetravel.dod.mil/site/travelre g.cfm

DAM PAM 40-501

Hearing Conservation

1/8/2015 https://armypubs.army.mil/ProductMaps/PubFo rm/PAM.aspx

DA PAM 40-506

Vision Conservation

7/15/2009 https://armypubs.army.mil/ProductMaps/PubFo rm/PAM.aspx

DoDM 1000.13-M-V1

DoD Identification (ID) Cards

(Enclosure 2, paragraph 3.b)

01/23/2014

(Change 1:

07/28/2020 http://www.esd.whs.mil/Directives/issuances/do dm

Federal Information Processing

Standards (FIPS) Publication 201-

Personal Identity Verification

(PIV) of Federal Employees and

Contractors

(paragraph 9)

August http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIP

S.201-2.pdf

DoDM 5200.2 Procedures for the

DoD Personnel Security Program

(PSP)

04/03/2017 https://www.esd.whs.mil/Directives/issuances/d odm/

DoDI 5200.46

DoD Investigative and

Adjudicative Guidance for Issuing the Common Access Card (CAC)

09/09/14

(Change 1:

05/04/2018 https://www.esd.whs.mil/Directives/issuances/d odi/

Homeland Security Presidential

Directive (HSPD)-12

Policy for a Common

Identification Standard for Federal

Employees and Contractors

08/27/2004 https://www.dhs.gov/homeland-security-presidential-directive-12

DoDI 5400.11

Department of Defense Privacy and Civil Liberties Programs

01/29/2019 odi/

DoD 5400.11-R

Department of Defense Privacy

Program

05/14/2007 https://www.esd.whs.mil/Directives/issuances/d odm/

DoD 6055.05M CH 3

8/31/2018 https://www.esd.whs.mil/Directives/issuances/d odm/ https://www.acquisition.gov/?q=browsefar http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html https://www.acquisition.gov/dfars http://www.esd.whs.mil/Directives/issuances/dodm http://www.esd.whs.mil/Directives/issuances/dodm http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.esd.whs.mil/Directives/issuances/dodi/

Occupational Medical

Surveillance Manual

DoDD 8140.01

Cyberspace Workforce

Management

10/05/2020 odd/

DoD 8570.01-M

Information Assurance Workforce

Improvement Program

12/19/2005

(Change 4:

11/10/2015

DoD 5220.22-M

National Industrial Security

Program Operating Manual

(NISPOM)

02/28/2006

(Change 2:

05/18/2016

Army Directive 2014-05

Policy and Implementation

Procedures for Common Access

Card Credentialing and

Installation Access for Uncleared

Contractors

03/07/2014 https://armypubs.army.mil/ProductMaps/PubFo rm/ArmyDir.aspx

AR 11-34

The Army Respiratory Protection

Program

7/25/2013 https://armypubs.army.mil/ProductMaps/PubFo rm/AR.aspx

AR 25-2

Information Assurance

04/04/2019 http://armypubs.army.mil/ProductMaps/PubFor m/AR.aspx

AR 40-5

Army Public Health Program

5/12/2020 https://armypubs.army.mil/ProductMaps/PubFo rm/AR.aspx

AR 530-1

Operations Security

09/26/2014 http://armypubs.army.mil/ProductMaps/PubFor m/AR.aspx

AR 525-13

Antiterrorism

12/09/2019 http://armypubs.army.mil/ProductMaps/PubFor m/AR.aspx

AR 381-12

Threat Awareness and Reporting

Program (TARP)

(Section II, ¶ 2-4.b)

06/01/2016 http://armypubs.army.mil/ProductMaps/PubFor m/AR.aspx

AFI 10-245

Antiterrorism

03/28/2013

(Certified current

03/30/2017 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1& series=-1&modID=449&tabID=131

AFI 31-101

Security Forces Standards and

Procedures

08/18/2020 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1& series=-1&modID=449&tabID=131

AFMAN 31-113

Security Forces Standards and

Procedures

03/05/2013

Change 1:

12/02/2015 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1& series=-1&modID=449&tabID=131 https://www.esd.whs.mil/Directives/issuances/dodd/ https://www.esd.whs.mil/Directives/issuances/dodd/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AFPD 17-1

Information Dominance

Governance and Management

04/12/2016 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1& series=-1&modID=449&tabID=131

AFMAN 17-1301

Computer Security (COMPUSEC)

02/12/2020 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1& series=-1&modID=449&tabID=131

AFI 10-701

Operations Security

7/24/2019

(Change 1:

06/09/2020 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1& series=-1&modID=449&tabID=131

Title 29, CFR, Part 1910:

Occupational Safety and Health

Standards

1/10/2022 https://www.ecfr.gov/current/title-29/subtitle-

B/chapter-XVII/part-1910?toc=1

29 CFR, Title 1960: Safety and

Health Provisions for Federal

Employees

1/10/2022 https://www.ecfr.gov/current/title-29/subtitle-

B/chapter-XVII/part-1960?toc=1

29 CFR Title 1910.120 Medical

Surveillance

1/10/2022 https://www.ecfr.gov/current/title-29/subtitle-

B/chapter-XVII/part-1910/subpart-H/section-

1910.120

American National Standards

Institute (ANSI) 288.6-1884, American National Standard for

Respiratory Protection, Respirator

Use, Physical Qualifications for

Personnel https://www.ansi.org/

Threshold Limit values and

Biological Exposure Indices

(TLVs), American Conference of

Governmental Industrial Hygienist

(ACGIH)

https://www.acgih.org/?s=Threshold+Limit+val ues+and+Biological+Exposure+Indices+%28T

LVs%29

6.1 Applicable Forms: Forms applicable to the PWS are listed below:

Form Date Website

DD 1172-2

Application for Identification

Card/DEERS Enrollment

Mar 2017 http://www.dtic.mil/whs/directives/forms/index.htm

I-9

Employment Eligibility

Verification

10/21/2019 https://www.uscis.gov/sites/default/files/files/form/i-

9.pdf

DD 441

Department of Defense Security

Agreement

Feb 2020 http://www.dtic.mil/whs/directives/forms/dd/ddforms000

1-0499.htm

DD 250 Aug 2000 https://www.esd.whs.mil/Directives/forms/dd0001_0499/ http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/index.htm https://www.uscis.gov/sites/default/files/files/form/i-9.pdf https://www.uscis.gov/sites/default/files/files/form/i-9.pdf http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm https://www.esd.whs.mil/Directives/forms/dd0001_0499/

Material Inspection and

Receiving Report

(End of paragraph 6.0)

TECHNICAL EXHIBIT 1

Performance Requirements Summary (PRS)

This PRS includes performance objectives the Government will use to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

Performance

Objective

Performance Standard Acceptable Quality

Levels (AQL)

Surveillance Method / By

Whom

1.4.7.1

Procedures

Contractor shall ensure all procedures are conducted in accordance with applicable

American Board of

Occupational and

Environmental Medicine

(ABOEM), American

Association of Occupational

Health Nurses (AAOHN), U.S. Department of Labor, Occupational Safety and

Health Administration

(OSHA), and the National

Institute for Occupational

Safety and Health (NIOSH)

Standards.

Contractor shall these procedures are followed 100% of the time during the event.

Daily/COR

1.4.7.2

Laboratory

Licenses

Contractor shall ensure all clinical laboratory services are performed by a laboratory licensed through the U.S. Department of

Health and Human Services

(DHHS), Health Care

Financing Administration pursuant to the terms of the

Clinical Laboratories

Improvement Act of 1967

(42 U.S.C. 263a) and the

College of American

Pathologies.

Contractor shall ensure services are performed by licensed laboratory

100% of the time

Random Inspection/COR

5.4 Medical

Services

The contractor shall provide those medical services IAW task 5.4.1 – 5.4.9

Contractor must perform 100% of these services everyday during the scheduled event.

Daily/COR

5.7 Medical

Reporting

The contractor shall provide the medical reports IAW task 5.7.1 – 5.7.3.

Contractor must provide 100% of the required reports.

Random Inspection/COR

5.8 Summary

Report

The contractor shall provide a summary report IAW 5.8

Contractor shall provide 100% of the required reports.

Random Inspection/COR

(End of Technical Exhibit 1)

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference /

Deliverable Title

Frequency Number of

Copies

Medium/Format Submit To

1.4.3 Quality

Control Plan

Provide within 10 calendar days after contract award.

1 Electronic

Submission

COR

1.4.5.3 AT Level

1 Awareness

Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic

Submission

COR

1.4.5.4 iWATCH

Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic

Submission

COR

1.4.5.11 OPSEC

Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic

Submission

COR

1.4.5.12 TARP

Training

Certificates

Provide within 15 calendar days after training completion.

1 Electronic

Submission

COR

1.4.7.2 Approved

Laboratories

Provide list of laboratories within 10 calendar days of award.

1 Electronic

Submission

COR

1.4.7.3 Medical

Licenses

Provide copy of licenses within 10 calendar days of award

1 Electronic

Submission

COR

1.4.7.4 Medical

Licenses

Provide copy of license within 10 calendar days of award

1 Electronic

Submission

COR

1.4.9 Contract

Manager (CM)

Provide name and qualifications of

Contractor Manager within 10 calendar days of award.

1 Electronic

Submission

COR

5.2

Comprehensive

Review

Provide review within 30 calendar days of event.

1 Electronic

Submission

COR

5.3 Provide copy

of proposed reports.

Provide copies of reports

NLT 30 days prior to start of event.

1 Electronic

Submission

COR

5.4.4 Daily

Calibration of

Spirometer

Provide copy of results of daily calibration of

Spirometer.

1 Electronic

Submission

COR

5.4.5 Respirator

Clearance

Provide documentation to Government employee at time of visit

1 Hard Copy Government

Employee

5.12 HIPAA

Training

The contractor shall provide copies of the each employee's training certificate NLT15 days prior to the schedule event.

1 Hard Copy COR

(End of Technical Exhibit 2)

TECHNICAL EXHIBIT 3

Historical Workload Data

This information is provided for historical background only. It is not a guarantee of actual workload quantities.

ITEM NAME ANNUAL ESTIMATED

QUANTITY

1 FY21 242

2 FY20 300

(End of Technical Exhibit 3)

TECHNICAL EXHIBIT 4

Estimated Workload Data for All Period of Performances

Item Requirement

Maximum # of Employees

Per Item

01 HW/BMI/BP 400ea

02 Mailing Employee 400ea

03 Respirator Fit Test 30ea

04 Report OHN 400ea

05 Lab (CMP, CBC) 400ea

06 Pulmonary Function

Test 30ea

07 Medical/Work History 400ea

08 Lead/ZPP 20ea

09 Vision Screening 400ea

10 Master Summery

Report 1ea

The above quantities are the best estimates the Government can provide. The actual quantity at each event could be more or less due to unexpected mission changes such as state emergencies or deployments which are beyond the control of the South Carolina National Guard. The contractor agrees to invoice the Government for the actual number of services rendered per item at each event.

(End of Technical Exhibit 4)