Attachment A QASP.docx

Quality Assurance Surveillance Plan For United States Army Reserve Command Safety Office Occupational Health/Medical Surveillance Physicals Services

1. Purpose. This Quality Assurance Surveillance Plan (QASP) is a government developed and applied document used to provide a standard of surveillance for monitoring the contract and provides the approach the government will use to conduct surveillance over the performance aspects of the effort. The intent is to ensure the contractor performs in accordance with performance metrics set forth in the contract documents, the government receives the quality of services called for in the contract, and the government only pays for the acceptable level of services received.

2. Scope.

The QASP is established to provide government surveillance oversight of the contractor’s quality control efforts to assure they are timely, and effective, and results are performed as specified in the contract. The QASP is not a part of the resulting contract nor is it intended to duplicate the contractor’s internal quality management efforts.

3. Government Roles and Responsibilities. The following personnel shall oversee and coordinate surveillance activities.

3.1. Contracting Officer (KO). The KO is responsible for monitoring contract compliance, contract administration, and cost control and for resolving any differences between the observations documented by the Contracting Officer’s Representative (COR) and the contractor. The KO will designate a COR as the government representative for performance management. The number of additional government representatives serving as inspectors depends on the complexity of the services measured, as well as the contractor’s performance, and must be identified and designated by the KO.

3.2. COR. The COR is designated in writing by the KO to act as his or her authorized representative. The COR will assist the KO with the technical administration of the contract to ensure proper government surveillance of the contractor’s performance. Any COR limitations will be identified with the designation letter. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the government’s behalf. Any changes the contractor deems may affect contract price, terms, or conditions shall be referred to the KO for action. The COR is responsible for quality assurance (QA) monitoring and completion of forms/reports used to document the inspection and evaluation of the contractor’s work performance. Government surveillance may occur under the terms and conditions of the contract for inspection.

3.3. Other Key Government Personnel. Upon award, the government may enter performance monitors, clinical quality experts, etc., who may provide input to the COR for reporting purposes.

3.4. The following contractor point of contact will serve as the contractor’s representative for this contract: (Upon award, government will enter name(s)).

4. Inspection Instructions.

4.1. The contractor shall develop and maintain an inspection plan acceptable to the government that encompasses all functions of the contract. Complete records of all inspection work performed by the contractor will be maintained and made available to the government during contract performance. Contractor will act upon request for records of inspection in a reasonable and timely manner.

4.2. If any of the services do not conform to contract requirements, the government may require the contractor to perform the services again in conformity with contract requirements, at no additional cost to the government. When the defects in services cannot be corrected by reperformance, the government may require the contractor to take necessary action to ensure that future performance conforms to contract requirements and reduce the contract price to reflect the reduced value of the services performed.

4.3. The government has the right to inspect and test all services called for by the contract, to the extent practicable at all times and places during the term of the contract. The government shall perform inspections and tests in a manner that will not unduly delay the work.

4.4. If the contractor fails to promptly perform the services again or to take the necessary action to ensure future performance in conformity with contract requirements, the government may, by contract or otherwise, perform the services and charge to the contractor any cost incurred by the government that is directly related to the performance of such service; or terminate the contract for default.

4.5. If the government performs inspections or tests on the premises of the contractor or a subcontractor, the contractor shall furnish, and shall require subcontractors to furnish, at no increase in contract price, all reasonable facilities and assistance for the safe and convenient performance of these duties.

5. Methods of Inspection.

5.1. The below listed methods of surveillance may be used in the administration of this QASP. They can occur quarterly, monthly, or as needed:

5.1.1. 100% Inspection. The COR may conduct 100% inspections of the work defined in the performance work statement (PWS). The COR will also review information submitted in the required reports defined in the PWS (if applicable).

5.1.2. Periodic Inspection. The government may conduct periodic inspections monthly, quarterly, or on an as-needed basis. The periodic inspection shall be conducted by the COR.

5.1.3. Random Inspection. The government may conduct random monitoring by reviewing information/reports required and submitted in accordance with the contract. The random monitoring shall be performed by the COR.

5.1.4. Performance Evaluation Meetings. The contractor and the COR will meet as often as necessary to review the contractor’s performance and address any contract discrepancy reports (CDRs) issued during the period. A mutual effort will be made to resolve identified issues.

5.1.5. Customer Feedback – The COR may provide and collect customer surveys or complaints regarding performance. A mutual effort will be made to resolve any problems/issues identified.

6. The level of surveillance may be conducted on a monthly, quarterly or as-needed basis and an analysis of the results will determine if the contractor met the standards or did not met the standards identified in the PWS/contract.

7. Performance Requirements Summary (PRS).

8 Rating

The Government will rate performance using the following performance standards.

Government Performance Rating Standards

Performance Requirements Summary The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

9. Successful Performance.

9.1. Successful performance can be incentivized with favorable past performance ratings and the potential award of follow-on opportunities.

9.2. Acceptable services for performance is demonstrated by an accepted and executed certified invoice and receiving report, as applicable.

United States Army Reserve Command Safety Office Occupational Health/Medical Surveillance Physicals Services Technical Exhibit A – Performance Requirement Summary

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports. Equitable adjustment or adequate consideration.

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports, Equitable adjustment or adequate consideration.

5.3.3 5.3.4

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports, Equitable adjustment or adequate consideration.

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports, Equitable adjustment or adequate consideration.

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports, Equitable adjustment or adequate consideration.

Abnormalities in lab or test results

5.3.6

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports, Equitable adjustment or adequate consideration.

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports, Equitable adjustment or adequate consideration.

Random Monitoring (reports) Re-Performance, Price Reduction for Substandard Performance, Favorable or unfavorable CPAR Reports, Equitable adjustment or adequate consideration.

5.6.1

Random Monitoring (reports) Performance will be documented in CPAR

Required Forms.

Exhibit’s:

D, F, H, and K

Random Monitoring (reports) Performance will be documented in CPAR

9.3. The acceptable quality level (AQL) consists of the performance standards established for the services required by the government to meet contract requirements. The AQL will be measurable and structured to permit an assessment of the contractor’s performance.

10. Documentation of Surveillance.

10.1. Effective contract surveillance relies on the COR identifying and documenting discrepancies during performance of routine daily services, or through the contractor’s quality control program. The COR will report discrepancies to the contractor for timely resolution. Surveillance may consist of periodic reports, and customer feedback and timeliness of contract deliverables/reports.

102. The COR will maintain a complete QA file which will be retained by the COR for the life of the contract. Information in the QA file will be considered when completing the annual CPARS report.

10.3. Documented surveillance will consist of inspections performed by the COR. All paperwork that supports contract surveillance such as details of inspections or data gathering, conversations or meetings with the contractor, notes and comments that support inspection paperwork, to include quality assurance surveillance reports. If performance is deemed unacceptable, the COR will inform the contractor. Disagreements or disputes will be referred to the KO for re-address.

10.4. All documentation resulting from surveillance will be made a part of the contract file. The COR must keep the documentation files during the surveillance period, but at the conclusion of the contract and as directed by the KO, the COR must give the files to the KO for inclusion in the official contract file.

11. Corrective Actions.

11.1. The contractor will be provided the opportunity to submit proposed corrective action to resolve the discrepancy. The COR will review proposed corrective action and determine whether or not it is acceptable and whether or not the discrepancy has been corrected. If the discrepancy has been resolved, the COR will notify the contractor and document the quality assurance surveillance checklist.

11.2. The COR will notify the contracting officer of unacceptable performance if any services do not conform to contract requirements. The contracting officer may require the contractor to re-perform the services to conform with contract requirements at no additional cost to the government.

11.3. When unacceptable performance cannot be corrected by re-performance, the government may require the contractor to take action necessary to ensure future performance conforms to contract requirements.

11.4. The government may exercise other such legal remedies as the KO deems appropriate, for example:

11.4.1. Cure Notice.

11.4.2. Show Cause.

11.4.3. Terminate the contract for cause.

12. Certification of Services: Certification of services is performed by the COR via the Invoice, Receipt, Acceptance, and Property Transfer (iRAPT) system. At the end of each billing period, the contractor inputs invoice information into iRAPT system. iRAPT automatically notifies the appropriate COR via email of pending invoice. COR accesses iRAPT and verifies the accuracy of services provided by the contractor. The COR will certify the invoice and payment is conducted by the Defense Finance Accounting System (DFAS). If the COR encounters errors in the contractor’s invoice, the COR will reject the invoice, state the reason for rejection and send back to the contractor. If the contractor disagrees with the COR, the issue will be forwarded to the KO for resolution.

12. QASP Checklist, Enclosure 1 to QASP

13. Contract Discrepancy Report (CDR), Enclosure 2 to QASP

14. Medical Examination Service Survey, Enclosure 3 to QASP

Enclosure 1 to QASP QASP Checklist

PHYSICAL EXAMINATION SERVICES:

Firefighters Physical Examination IWA IAW NFPA Standards 1582

DoD Police and Guards Physical Exam IAW DoD 6055.05-M

Maintenance Shop Personnel Physical Exam IAW DoDi 6055.05-M

Emergency Essential Occupational Health Safety Specialist Physical Exam IAW DoDi 6055.05-M

Commercial Motor Vehicle Operators Medical Certification (CDL) physical examination IWA 49 CFR 391.41

SURVEY PERIOD: ___________________________________________________________

SURVEILLANCE METHOD (CHECK):

100% Inspection

Periodic Inspection

Random Monitoring (reports)

Performance Evaluation Meetings

Customer Feedback

LEVEL OF SURVEILLANCE (CHECK):

Monthly

Quarterly

As needed

PERCENTAGE OF ITEMS SAMPLED DURING SURVEY PERIOD:

ANALYSIS OF RESULTS:

Observed Service Provider Performance Measurement Rate:

Service Provider’s Performance (Check):

Meets Standards

Does Not Meet Standards

Narrative of Performance during Survey Period:

Printed Name:

Date:

Signature:

Enclosure 2 to QASP Contract Discrepancy Report

CONTRACT DISCREPANCY REPORT

5. DATES (YYYYMMDD)

6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.)

7. SIGNATURE OF CONTRACTING OFFICER

9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE.(Cite applicable Q.C. program procedures or new Q.C. procedures. Attach continuation sheet(s) if necessary.)

11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary)

12. GOVERNMENT ACTIONS (Reduced payment, cure notice, show cause, other)

13. CLOSE OUT

(4)

a. CONTRACTOR NOTIFIED

b. QAE

c. ACO

DD FORM 2772, SEP 1998 REPLACES MT FORM 352-R, WHICH IS OBSOLETE.

Enclosure 3 to QASP Medical Examination Service Survey

DEPARTMENT OF THE ARMY

HEADQUARTERS, UNITED STATES ARMY RESERVE COMMAND SAFETY DIRECTORATE

4710 KNOX STREET FORT BRAGG, NC 28310-5010

MEMORANDUM FOR RECORD

SUBJECT: Physical Examination Service Survey

1. The U.S. Army Reserve Safety Directorate values your feedback. Please complete this survey on your experience for the physical examination service you recently received. Once completed please return this survey to your Department Chief. Your Department Chief will collect and forward the survey to U.S. Army Reserve Safety Directorate point of contact. Thank you for taking the time to provide your feedback to assist us to improve the services provided to you.

Employee Name: ________________________ Physical Exam Date: ________________

Clinic Name: ____________________________ City/State: __________________________

Survey Questions

Strongly Disagree

Disagree Neither Agree nor Disagree

Agree

Strongly Agree

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