Attachment 03 W912L5-24-Q-0001 Occupational Health Exams PWS.pdf

PERFORMANCE WORK STATEMENT

FOR

Delaware Army National Guard Occupational Health Medical Surveillance

1.0. General:

1.1. Scope: Delaware Army National Guard (DEARNG) Occupational Health seeks qualified contracted services for a mobile Occupational Health unit to conduct job-related medical surveillance screening examinations and Occupational Health services for employees who have the potential to become exposed to health hazards in the work environment.

1.2. Background: In accordance with (IAW) the Occupational Safety and Health Administration (OSHA), Title 29 Code of Federal Regulations (CFR) § 1910, Army Regulation (AR) 40-501 Standards of Medical Fitness, National Guard Regulation (NGR) 40-5, The Army National Guard Preventive Medicine Program, AR 40-5 Preventive Medicine, and Department of Defense Instruction (DoDI) 6055.05-M, Occupational Medical Examinations and Surveillance Manual, employees must be monitored for the impacts of workplace exposures (known and potential) and provided medical surveillance evaluations based on job code and/or identified exposures. The medical surveillance program is a risk based medical screening and examination process intended to improve combat readiness through early recognition and prevention of occupational exposure. The program incorporates various elements that identifies employee workplace exposures to physical, chemical, biological, or radiological hazards, the effects for such exposure and directs measures to prevent occupational illnesses and injuries associated with these exposures. Program requirements vary based on the individual’s job code, the type of work performed, and the exposures at the worksite. Industrial hygiene surveys are conducted to identify hazards and measure exposure levels of known hazards based on the individual and the task, separating potential exposure from actual exposures.

1.2.1. In accordance with the requirements of the Office of Personnel Management for specific job codes and data obtained from Industrial Hygiene surveys, screening is required for employees exposed to potential health hazards in the workplace.

1.2.2. While many hazards are mitigated through engineering controls, employees are provided with personal protective equipment for known hazards that are not mitigated by engineering controls or administrative controls.

1.2.3. Medical surveillance screens for health risks and impacts from known and/or unknown exposures that may or may not be related to their occupation; ensures the fitness of employees to perform tasks safely and examines the ability of an employee in the use of personal protective equipment when required.

1.2.4. Employees exposed to a potentially hazardous environment or operation are required to obtain a medical surveillance examination as a baseline or prior to placement, semiannually dependent on exposure, annually, and upon termination of exposure or removal from hazardous duty. Some employees may require monitoring after termination from position to monitor for long term effects of exposures.

1.3. Period of Performance: The period of performance shall be May through August 2024.

1.4. General Information:

1.4.1. Place and Performance of Service: Services will be provided on site at the designated locations listed in paragraph 1.4.2. It is expected that the contractor will be onsite, on time, and ready to receive customers at the pre-determined start time.

Services shall be provided between the hours of 0700-1700 Monday through 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. The contractor will dictate the capacity during the planning phase to determine the number of days at each site. The contractor shall always 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.

1.4.2. Mobile services will be provided at the following locations but may change based on any additional support maintenance facilities added within the state:

1.4.2.1. Army Aviation Support Facility (AASF), 33 Corporate Circle, New Castle, DE 19720

1.4.2.2. Combined Support Maintenance Shop (CSMS), 1197 River Road, New Castle, DE 19720. This location will include employees of Facility Maintenance Shop (FMS) #3 and Facility Maintenance Shop (FMS) #1. These shops are all located within the same installation.

1.4.2.3. Facility Maintenance Shop (FMS) #4, 23440 Ross Station Road, Seaford, DE 19973.

1.4.2.4. Facility Maintenance Shop (FMS) #5, 29691 Armory Road, Dagsboro, DE 19939.

1.4.3. In recognition that circumstances may prevent some employees from attending scheduled mobile Occupational Health services, the contractor shall offer alternative options to ensure all employees receive necessary services. The specific arrangement for accommodating the employee will be determined in consultation between the contractor and the Contracting Officer Representative (COR) prior to services being scheduled.

1.4.4. Telework: N/A

1.4.5. 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 and shall comply with the local installation requirements for vehicle registration/operation on the military facility. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.6. 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 always carry proper identification with them 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.

1.4.7. Recognized Holidays: The following link contains recognized US holidays and the organizations observed days off. The contractor shall not perform services on these days: Federal Holidays (opm.gov)

1.4.8. Quality Control (QC): The Contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed IAW this PWS. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services.

1.4.9. Quality Assurance (QA): The Government shall evaluate the Contractor’s.

performance under this contract IAW the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government will do to ensure that the contractor has performed IAW 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).

1.4.10. 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. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.10.1. For contractors that do not require a Common Access Card (CAC) but require access to a DoD facility or installation: The contractor shall comply with the local installation requirements for vehicle registration and operation on the military facility. In addition, the contractor must comply with the local installation and facility personnel requirements for identification and access to site. Coordination will be made with the COR upon award of services for all employees. Any vehicle operated by the contractor in performance of this service must have the minimum liability coverage required by the state in which the installation is located.

1.4.11. Antiterrorism Awareness Training Level 1: All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete Antiterrorism Awareness Training Level 1 within 30 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. Antiterrorism Awareness Training Level 1 awareness training is available at the following website: https://jko.jten.mil/courses/AT-level1/launch.html.

1.4.12. 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). 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 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR, within 15 calendar days after completion of training.

1.4.13. Confidentiality. The contractor shall abide by Army Regulation (AR) 40-66, Medical Record Administration and Healthcare Documentation, concerning the nature of limited privileged communication between patient and provider for security and personnel reliability programs. The contractor shall abide by AR 40-66 concerning confidentiality of patient records, as embodied in federal statues including the Privacy Act of 1974 and the Drug and Alcohol Act, Public Law 92-129.

1.4.14. 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 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.

1.4.15. OPSEC Training: N/A

1.4.16. 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.

1.4.17. 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 with the contractor to review the contactor’s performance. 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.

1.4.18. 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.

1.4.19. 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.

1.4.20. 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.

1.4.21. Contractor Travel. The Contractor shall travel to the designated locations outlined in paragraph 1.4.2. of this contract to conduct services outlined within this

PWS.

1.4.22. 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.

1.4.23. N/A

1.4.24. Conduct: The Contractor and contractor employees must always be professional with good customer service.

1.4.24.1. All providers and technicians accessing patient records, data or obtaining health information must complete the annual training and comply with the requirements of the HIPAA Act of 1996.

1.4.24.2. Personal appearance. The Contractor and staff shall present a professional appearance and always conduct themselves in a professional manner.

1.4.24.3. Contractor and staff will present with good personal hygiene and ensure clothing is clean and neat on their person.

1.4.24.4. Clothing will not be derogatory or offensive in nature or suggestive of sexual behavior or conduct unbecoming in the presence of employees.

1.4.24.5. The Contractor shall abide by applicable laws and regulations governing the safety and health programs.

1.4.25. Conflict of Interest: The Contractor shall not introduce any new services without prior approval of the COR. In disagreements or deviations from established protocols, COR will be the deciding authority.

1.4.25.1. The Contractor shall not use services rendered pursuant to this agreement as part of a study, research grant, or publication without the prior written consent of the

KO.

1.4.25.2. The Contractor shall not bill the patient, an insurer, or anyone else for services rendered. The only compensation the Contractor is entitled to for performance of the contract is payment as specified by this contract. The Contractor and staff are not prohibited, under this contract, from conducting private medical practice if there is no conflict with the performance of duties under this contract and the Contractor and staff does not use DEARNG facilities or other DEARNG property in connection therewith.

1.4.25.3. The Contractor and staff shall not be an employee of the United States government if the employment would create a conflict of interest.

1.4.25.4. The Contractor shall be responsible for complying with all installation safety requirements in accordance with OHSA regulations. Such regulations include but are not limited to, general safety, fire prevention and waste disposal.

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 a 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:

AAOHN American Association of Occupational Health Nurses AASF Army Aviation Support Facility ABOEM American Board of Occupational and Environmental Medicine AR Army Regulation BBPSM Blood Borne Pathogens Standards Manual BCOHP Board Certified Occupational Health Physician BL Blood Lead CAOHC Council for Accreditation in Occupational Hearing Conservation CBC Complete Blood Count CdB Blood Cadmium CdU Urine Cadmium CFP/M/E Contractor Furnished Property, Materials, and Equipment CFR Code of Federal Regulations CM Contract Manager CMP Comprehensive Metabolic Panel CSMS Combined Support Maintenance Shop COMSEC/IT Communications Security/Information Technology COR Contracting Officer Representative CXR Chest X-Ray DEARNG Delaware Army National Guard DA Department of the Army DA PAM Department of the Army Pamphlet DHHS Department of Health and Human Services DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense DoDD Department of Defense Directive DoDI Department of Defense Instruction FAR Federal Acquisition Regulation FFD Fit for Duty FMS Field Maintenance Shop FPCON Force Protection Condition

GFP/M/E/S Government Furnished Property/Material/Equipment/Services HIPAA Health Information Portability and Accountability Act HQDA Headquarters, Department of the Army IA Information Assurance IAW In Accordance With KO Contracting Officer NGB National Guard Bureau NGR National Guard Regulation NIOSH National Institute for Occupational Safety and Health OCI Organizational Conflicts of Interest OHN Occupational Health Nurse OSHA Occupational Safety and Health Administration PFT Pulmonary Function Test PHI Protected Health Information PII Personally Identifiable Information 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 UA Urinalysis ZPP Blood Zinc Protoporphyrin

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 DEARNG will provide the contractor with adequate locations for medical surveillance screening examinations and Occupational Health services.

3.2. Materials: Medical documentation related forms will be issued directly to each employee by the DEARNG OHN prior to their scheduled appointment. The contractor will be given the opportunity to review all related forms prior to the start of each day.

3.3. Equipment: Government equipment will not be furnished for the purposes of this contract.

3.4. 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.

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

4.1. General: Contractor shall furnish equipment, labor and services required to provide Occupational Health medical surveillance examinations and services as prescribed by this document and the standards governing the Occupational Health profession.

Equipment and instrumentation must meet or exceed appropriate performance, calibration, and maintenance standards for accuracy IAW manufacturer guidelines, OSHA, and Department of Army regulations.

4.1.1. Contractor will provide the proper personal protective equipment to conduct medical surveillance screening examinations and Occupational Health services IAW Center for Disease Control guidelines as indicated in section 5.18. of this PWS.

4.1.2. The contractor must ensure licenses, registrations, credentials, equipment calibrations, provider accreditation, and training are current and in compliance with applicable standards. Documentation will be furnished to COR as requested.

5.0 Requirements:

5.1. Testing requirements for the medical surveillance examinations are as follows but not limited to: (cost by line item must be provided)

5.1.1. Audiogram-IAW Department of the Army Pamphlet (DA PAM) 40-506, Department of Defense (DoD) 6055.05-M (baseline, annual, transfer and/or termination)

5.1.2. Chest x-ray (CXR)-IAW DoD 6055.05-M (single view/ B reader with report only)

5.1.3. Lab work- IAW DoD 6055.05-M:

5.1.3.1. Complete Blood Count with differentials (CBC w/differential)

5.1.3.2. Comprehensive Metabolic Panel (CMP)

5.1.3.3. Heavy Metals

5.1.3.3.1. Blood Zinc Protoporphyrin (ZPP)

5.1.3.3.2. Blood Lead (BL)

5.1.3.3.3. Blood Cadmium (CdB) blood

5.1.3.3.4. Urine Cadmium (CdU)

5.1.3.4. B2 Microglobulin

5.1.3.5. Urinalysis (UA)- dipstick

5.1.4. Pulmonary Functions Test (PFT)-IAW DoD 6055.05-M (Spirometry)

5.1.5. Vision Screening-IAW DoD 6055-.05-M, DA PAM 40-506 (corrected near and distant monocular and binocular visual acuity, depth perception, color, confrontational visual fields).

5.1.6. Medical screening will consist of the following IAW DoD 6055.05-M: (cost by line item must be provided)

5.1.6.1. Medical History – past medical history, current, home exposures, work exposures, work related complaints (past and current), hearing, ergonomic, and vision.

5.1.6.2. Screening Exam – interview with employee to discuss available results and questionnaires and annotate notes in medical records.

5.1.6.3. Respiratory History/Clearance – IAW 29 CFR § 1910.134 App C and AR 11-34;

Review of spirometry results as applicable.

5.1.6.3.1. Personnel will be appropriately trained to perform qualitative and quantitative fit testing IAW appendix A of 29 CFR § 1910-134 for mandatory fit testing procedures.

5.1.7. Fitness for Duty (FFD)-IAW DoD 6055.5-M (determining whether an employee is medically and physically able to perform the assigned duties without substantial risk of harm to themselves, others, or the mission).

5.1.8. Test results that are received after the service date will be reviewed by a Board- Certified Occupational Health Physician (BCOHP) and provided to DEARNG Occupational Health Nurse (OHN) with relevant recommendations. In lieu of board certification, the medical provider should have at least three years of full-time clinical experience in adult primary care.

5.1.9. The services requested are for testing, screening and evaluation purposes therefore medical treatment is not required or authorized. In the event additional testing is required for a suspected occupational related issue consult with the COR prior to conducting.

5.2. Contractor will consult with the COR on health concerns involving employees that may arise during operations or upon receipt of results that are not readily available on site (i.e., blood pressure/lab results).

5.3. The privacy of the employee must be ensured at all times.

5.4. Test Panels. Testing will occur based on the requirements of the job code/job title and known or suspected exposures. The list of testing requirements for each employee will be provided by the DEARNG OHN to the contracted agency.

5.5. Contractor will provide a by name list of employees seen and test performed prior to departing the work site.

5.6. If abnormal findings are identified, the contractor shall notify the employee and the DEARNG OHN immediately.

5.7. Personnel files and medical information will only be sent to and discussed with the individual and DEARNG OHN.

5.8. Contractor will arrange for initial coordination of services with the designated COR within fifteen (15) working days after award of the contract. Instructions and required paperwork for employees will be forwarded to: Delaware Army National Guard, Occupational Health Office, 1 Vavala Way, New Castle, DE 19720, Attn: Occupational Health Nurse, and received no later than 15 days prior to start date of service.

5.9. The contractor shall abide by applicable Army regulations governing the handling and storage of medical records IAW AR 40-66.

5.10. Special Qualifications: It is the responsibility of the contractor to ensure the health care team are current and appropriately licensed, trained, boarded, and certified to perform medical surveillance screening and testing. License and certifications will be made available upon request. They will operate under the supervision and direction of a BCOHP provided by the contractor.

5.11.1. Personnel performing audiograms must have a current course completion of a Council for Accreditation in Occupational Hearing Conservation (CAOHC) or equivalent course work and able to perform an otoscopic examination IAW DA Pam 40-501. This certificate must be provided to verify training.

5.11.2. Personnel performing audiograms will ensure hearing aids and any other objects that may interfere with testing are removed prior to administering test.

5.11.3. The DD Form 2215 and DD Form 2216 are the forms of record for all audiograms and will be made available on each employee. The DD Form 2215 will be provided for all baseline hearing test and the DD Form 2216 will be provided for all annual tests. Each form will be signed by the examiner.

5.11.4. Audiometric testing will be conducted IAW DoDI 6055., 4(e) and DA PAM 40- 501, chapter 3, (3-6), chapter 7, (7-5) guidelines. DOEHRS-HC is not a requirement.

5.11.5. Contractor will ensure all equipment is appropriately licensed, calibrated, and maintained to the standards governing the use of equipment and the manufacturer’s guidance.

5.11.6. Annual comprehensive electro-acoustical calibration data for each audiometer must be provided to the COR within fifteen (15) days of each scheduled site location.

Daily calibration and functional checks will be provided to the COR on each day prior to the start of testing, COR will be onsite.

5.11.7. Audiometric testing must be conducted in a sound booth in a testing environment with noise levels not to exceed the requirements outlined in DA PAM 40- 501, Table 3-2.

5.11.8. Noise level measurements must be evaluated each time the mobile test booth moves to a new location and noted on the Audiometric Test Booth Certification Form, to be posted on the test booth(s) while testing.

5.11.9. Coordination for evaluation of noise levels will be facilitated by the COR.

5.12. The contractor must ensure all testing, evaluation and examination procedures are conducted IAW applicable American Board of Occupational and Environmental Medicine (ABOEM), American Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, OSHA, National Institute for Occupational Safety and Health (NIOSH) and other standards as applicable.

5.13. The Contractor shall provide a board eligible or BCOHP to conduct job-related/hazard based Occupational Heath medical surveillance examinations and Occupational Health consultation services IAW NGR 40-5. The BCOHP must be on site, between each DEARNG location IAW section 1.4.2. Provider will utilize historical records in the evaluation and examination of employee.

5.14. Employee records may be available upon request to the provider by the COR.

5.15. Personnel conducting pulmonary function testing will be certified through a program approved by the NIOSH and IAW 29 CFR § 1910.134.

5.16. Personnel will be appropriately trained and licensed to operate an x-ray machine.

The x-ray equipment will be in excellent working conditions, appropriately maintained, calibrated, and licensed prior to use: see appendix E of part § 1910.1001 for chest X- Ray schedule and B-reader requirements.

5.17. Personnel performing blood draw and lab operations will be trained and skilled in the task of specimen collection.

5.17.1. Contractor must 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 Pathologists. Equipment and instrumentation must meet or exceed appropriate performance, calibration, and maintenance standards.

5.18. The contractor shall adhere to the Centers for Disease Control guidelines, related to standard precautions, while providing services under this contract.

5.19. The process for the storage, transport and handling of specimens must be in place to ensure the quality of the specimen to be analyzed. The contractor will be responsible for specimens that are ruined due to reason not the fault of the employee and will coordinate for the re-collection of specimen(s) with the COR.

5.20. Personnel conducting visual acuity test will be trained and skilled in performance of task.

5.21. The DEARNG is not responsible for training contracted staff.

5.22. Documentation: All required forms will be provided by the DEARNG OHN to each employee. The employee is expected to have the required documents on their person, completed to their fullest capability, the day of their examination.

5.23. Contractor will consult with the COR to coordinate or resolve issues that may arise before, during, and after an examination.

5.24. Reports: Hard copies of medical examination results will be provided within 30 days of examination completion. Contractor shall ensure two copies of the employee’s examination findings are furnished. One copy shall be sent to the DEARNG OHN as designated in section 6.2. and one copy shall be mailed directly to the individual employee’s home of record within thirty (30) working days upon completion of testing services. Copies provided (sent) in bulk to the DEARNG OHN shall be sent in appropriately secured, correctly sized individual envelops not folded. If stapling is required; documents will be stapled in the upper left-hand corner. Medical examination results shall include all diagnostic tests, graphs, charts, reports, questionnaires, waivers, employee consent forms, physical findings, and examination results.

5.25. Examination results/reports, invoices, and any other correspondence will be addressed to DEARNG Occupational Health Nurse, 1 Vavala Way, New Castle, DE 19720. A Draft itemized invoice will be submitted to the DEARNG OHN via encrypted email, see section 6.2 for email address, within thirty (30) days of employee examination.

5.25.1. Contractor shall identify all medical records with the employee’s full name, last four digits of social security number, date of birth, and job code at a minimum. The Contractor shall ensure work / health history forms and medical reports are complete and legible (typed / printed) with the date of service annotated on each form.

5.25.2. The Contractor will provide a cover letter to each employee to whom exam results are sent. The letter will be individualized and will summarize in lay terms individual test results; along with any recommendations as warranted by results, for the employee to follow up with their personal physician as indicated. A copy of the cover letter will also be sent with the screening examination to the DEARNG OHN. At the discretion of the Contractor, a disclaimer may be added to the exam cover letter stating, “If you require further information, and or have questions related to the exam results;

you are welcome to reply within thirty days of receipt. If no response, we presume you acknowledge and accept”.

5.25.3. After approval of Draft Itemized invoice, contractor will submit invoice in WAWF, according to the contract. The invoice in WAWF will NOT contain PII information.

6.0. Additional Requirements and Notes:

6.1. The DEARNG has a strict policy against sexual harassment, sexual assault, and discrimination of any kind. Contractor and employees must not engage in these acts will treat everyone with respect and without discrimination based on gender, race, sexual orientation, or religious beliefs.

6.2. Initial coordination of services will be coordinated within fifteen (15) working days after award of the contract. Instructions and required paperwork from the agency will be forwarded to the COR at 302-326-7101, email elaine.d.matthews.civ@army.mil or by mail within 15 calendar days of service start date.

6.3. Point of Contact (POC) for this contract will be the DEARNG OHN, E. Denise Matthews. All correspondence will be addressed to: DEARNG, Attn: Occupational Health Nurse, 1 Vavala Way, New Castle, DE 19720.

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

Publication (Chapter/Page)

Website

Federal Acquisition Regulation https://www.acquisition.gov/?q=browsefar Defense Federal Acquisition Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.ht ml or https://www.acquisition.gov/dfars

AR 25-2

Information Assurance http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 530-1

Operations Security http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

Occupational Safety and Health Administration (OSHA) 29 Code of Federal Regulations (CFR) § 1910 https://www.osha.gov/laws-regs/regulations/standardnumber/1910

AR 11-34, The Army Respiratory Protection Program https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/ r11_34.pdf

AR 40-5, Preventive Medicine https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/ ARN16450_R40_5_FINAL.pdf

AR 40-66, Medical Record Administration and Healthcare Documentation r40_66.pdf

AR 40-501, Standards of Medical Fitness https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN377 20-AR_40-501-002-WEB-4.pdf

AR 381-12 Threat Awareness and Reporting Program

AR%20381-12%20FINAL%20WEB.pdf

AR 385-10, The Army Safety Program https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN349 81-AR_385-10-000-WEB-1.pdf

DA PAM 40-501, Hearing Conservation Program p40_501.pdf

DA Pam 40-506, The Army Vision Conservation and Readiness p40_506.pdf

DFARS 224.103, DFARS Personally Identifiable Information https://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.h tml

DoD 6055.05-M, Occupational Medical Examinations and Surveillance Manual https://www.esd.whs.mil/Portals/54/Documents/DD/issuan ces/dodm/605505m.PDF?ver=3u-UoR7v7wydz- RIKQkI_Q%3d%3d

NGR 40-5, The Army National Guard Preventive Medicine Program https://www.ngbpmc.ng.mil/Portals/27/Publications/ngr/ngr %2040-5.pdf?ver=2018-09-07-082539-203

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

Form Website

DD 2215

Reference Audiogram https://www.esd.whs.mil/Directives/forms/dd2000_2499/

DD 2216

Hearing Conservation Data https://www.esd.whs.mil/Directives/forms/dd2000_2499/

OSHA Respirator Questionnaire

Respirator MD Clearance

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

1.4.1 Contractor shall provide a

mobile unit onsite and on time.

Onsite mobile unit arrived on time to the designated

DEARNG facilities.

QASP report completed by

COR

1.4.14. The contractor shall abide by

the privacy of the employee

The contractor provided confidential areas at the time of examination for all services as well protected health information records.

QASP report completed by

COR

1.4.24.1 The contractor shall protect

all health information.

The contractor protected health information IAW with

HIPAA.

QASP report completed by

COR

1.4.17 Contractor will attend post

award conference and periodic progress meetings

Contractor attended all post award meetings and conference.

QASP report completed by

COR

1.4.18 Contractor is to designate a

POC in writing to the KO for contracting actions.

The contractor designated a contracting manager who is fully working with the KO and COR on contracting actions.

QASP report completed by

COR

1.4.25.4 Contractor will comply with

all installation safety requirements.

Contractors maintained safety compliance at all times.

QASP report completed by

COR

4.0 Contractor is to furnish the

equipment, labor, and services as prescribed by the

PWS

Contractor furnished required materials and equipment to perform services.

QASP report completed by

COR

5.0. The contractor will conduct

testing based upon the list provided to them by the DEARNG Occupational Health Nurse (OHN).

Testing requirements were conducted according to the spreadsheet provided by

DEARNG OHN.

QASP report completed by

COR

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.11.

Antiterrorism Awareness Training Level 1 Certificates

Provide within 15 calendar days after employee completes training.

1/Contractor Electronic Submission

COR

1.4.12.

iWATCH Training Certificates

Provide within 15 calendar days after employee completes training.

1/Contractor Electronic Submission

COR

5.24.

Employee Results

Contractor shall ensure two copies of the employee’s examination findings are furnished. One copy shall be sent to the DEARNG OHN as designated in section 6.2, and one copy shall be mailed directly to the individual employee’s home of record within thirty (30) working days upon completion of testing services.

2 Postal Service Employee and COR

5.6 If abnormal findings are

identified that may be a serious health concern, the contractor shall notify the employee and the DEARNG OHN immediately.

Abnormal findings, if any, were communicated immediately to the employee and DEARNG OHN.

5.10 It is the responsibility of the

contractor to ensure the health care team are current and appropriately licensed, trained, boarded, and certified to perform medical surveillance screening and testing.

Contractor provided licensing and certifications, to include calibration, prescribed in

PWS.