Attch 1 W912L523Q0030 PWS Dental August 2023.pdf

Performance Work Statement (PWS)

Dental Examinations and Restorative Care

PART 1

GENERAL INFORMATION

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, tools, materials, supervision, and other items and non-personal services necessary to perform restorative dental care and examinations for Soldiers in the Delaware Army National Guard as defined in this Performance Work Statement (PWS); except as

Specified in section C-3 as government furnished property and services within the state of Delaware. The contractor shall perform to the standards in this document.

1.2 Background: Our ability to provide ready forces to Combatant Commanders and a capability to the Governor for

Defense Support of Civil Authorities is predicated upon the readiness of our Soldiers. Dental Readiness Classification

(DRC) is a basic principle of force-sustainment for Delaware Army National Guard (NGDE) forces. Specifically, DRC sustainability is a vital element for comprehensive force health protection and failure to achieve optimum dental health could preclude a Soldier from deploying and threatens homeland defense capabilities. Dental readiness is a command responsibility and is now a primary focus in the NGDE.

1.2.1 Policy Background: The performance work statement includes the components of dental classifications for the

Department of Defense (DOD) in order to identify varying degrees of dental health and readiness. This is to cover the various components of DRC to include: annual dental exams, digital bitewing radiographs, digital panoramic radiographs, DENCLASS data entry of all radiographs and dental records, identification and treatment of all Class 3 soldiers on alert orders and/or eligible through the Army Selected Reserve Dental Readiness System (ASDRS)

Program. All Services (except extensive Class 3b and 3c Soldiers that require in-clinic treatment and or dental reconstruction) must be initiated on site at NGDE Armories, Training Sites, and Facilities across the State. The PWS identifies the purpose of the work to be performed by the contractor and provides a description of the work to be completed and required outcomes. The contractor shall provide qualified personnel with current Delaware State

Dental Licensure , material to perform the services, and /or OSHA, HIPAA, ADA, and Privacy Act Compliant

Portable Dental Practice (able to be set up in NGDE Armories, Training Sites, and Facilities armory or similar building depending on the individual site needs for the NGDE).

DoD established a uniform dental classification in HA Policy 02-11. DoD policy requires dental screening examinations and remediation to be accomplished and documented on 100% of service members for any particular dental event. Members of the NGDE shall receive an annual dental screening examination to determine their dental classification. As well, Soldiers alerted and on Mobilization Orders (or eligible through the ASDRS Program) are eligible for dental restorative services if they are Class 3 status from examination or are notified outside of the 12 month mobilization window. The results of that screening examination shall be entered into the DENCLASS database at the actual time of examination. The DENCLASS database updates the Army Medical Protection System, MEDPROS. Every possible and achievable dental restorative service for any NGDE Soldier (or mobilizing with a

NGDE unit) is essential at the SRP site to ensure the highest dental classification and to ensure deployability of the

Soldier(s).

1.3 Objectives and Scope: The objective of this PWS is to conduct and complete the requirements of DRC on all eligible Soldiers in the NGDE (or mobilizing with a NGDE unit) utilizing a HIPAA, Privacy Act, and OSHA-

Compliant portable dental facility for the NGDE. This includes the requirement to provide all management, labor, examination materials, equipment, certifications and supplies required to provide dental treatments per identified/approved treatment plan to upgrade Class 3 or Class 4 Soldiers to a Class 2 or 1 status (Definition of Dental Classifications can be found in Part 2 of this PWS). Contractor shall demonstrate ability to perform these services, assess and treat the Soldier efficiently, as well as provide individual case management of Soldiers, schedule dental appointments for Soldiers (at selected dental facilities throughout Delaware for Class 3b and Class 3c Soldiers) and provide individual consultation by a dentist, should a Soldier desire. These services will provide dental treatments necessary to meet Department of the Army standards of readiness and deployability (Class 2) with the oversight and ultimate approval authority by the NGDE State

Dental Surgeon, State Surgeon and Deputy State Surgeon. In accordance with the PWS, the following tenets are also applicable:

• Clinical evaluation by a licensed dentist of the oral cavity using visual, clinical exam supported by bitewings taken by certified dental technicians.

• Individual case management, accountability and vendor oversight provided by a qualified and credentialed Dental Director (licensed DDS or DMD). This position shall be a staff position of the prime vendor.

• Pre-event scrub of records through DENCLASS, ADDRs or CDR

• Staff a dedicated and organic emergency 1-800 # (manned 24/7) call line for Soldiers to call, should dental emergencies emerge upon completion of dental work.

• Oral surgery on location and Endodontic treatment on location

• “Chair-side” dental classification entry by organic staff (i.e., not sub-contracted or “third party vendor” data entry), entered “real-time” (provided internet operability – 5 business days from the event if no connectivity) into the DENCLASS reporting system and annotated on the SF 603

(Health Record – Dental) and the SF 5570 (Health Questionnaire for Dental Treatment) of the

Soldier’s dental records.

• All access to MODS modules (www.mods.army.mil) will be performed by awarded vendor and

NOT sub-contracted data entry by second or third-party entities.

• Personnel performing the dental screening examination have a moral and ethical obligation to inform the Soldier if they observe to be apprised of any sign or symptom for which the Soldier should obtain further evaluation or care.

• Conduct training, as needed, to NGDE staff of modules, systems and equipment on-location or off-site, as needed.

• Provide “real-time” pharmacy prescriptions for each restorative event (and qualified staff to obtain medications) for any Soldier requiring medications post-event.

• Provide a qualified bio-medical machine technician for each examination, in case of equipment failure.

• Provide dental screening examination to identify deficiencies.

• Must be able to perform and provide examination services

• Submit a detailed list of services performed upon completion of the event(s).

• Provide a dedicated contract liaison to case manage each examination or restorative service, either on-site or off-site.

1.4 Period of Performance:

Base: Saturday, 5 August

Sunday, 6 August

1.5 General Information

1.5.1 Quality Control: The contractor shall maintain an effective quality control (QC) program to ensure services are performed in accordance with this PWS.

1.5.2 Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government http://www.mods.army.mil/ must 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 the minimum acceptable defect rate(s).

1.5.3 Government Remedies: The contracting officer shall follow FAR 52.212-4, “Contract Terms and Conditions-

Commercial Items” or 52.246-4, “Inspection of Services-Fixed Price” for contractor’s failure to perform satisfactory services or failure to correct non-conforming services.

1.5.4 Recognized Holidays: No holidays fall within this timeframe.

1.5.5 Hours of Operation/Place of Performance: The contractor is responsible for conducting dental exams and restorative care between the hours of 0700-2000 hours during this period of performance. Location is the Delaware

National Guard Headquarters, 1 Vavala Way, New Castle DE 19720.

1.5.5.1 Site Visit: Due to limited time, a site visit will not be conducted.

1.5.6 Type of Contract: The government intends to establish a one-time Firm Fixed Price contract for the month of

August.

1.5.6.1 Evaluation Factors: Proposals will be evaluated and awarded to the offeror who offers the best value in accordance with the following evaluation factors for this requirement. Clause 52.212-2 Evaluation—Commercial

Items shall be used to evaluate offers:

Price

Past Performance

Technical Quality

Technical and past performance, when combined, are approximately equal to price.

1.5.7 Travel Requirements: Contractor will be fully responsible for the travel and all expenses for their staff. The offeror must understand that no personal and/or travel expenses will be reimbursed and will be the complete responsibility of the contractor.

1.5.8 Qualifications: Contractors must have a full comprehension of Individual Medical Readiness (IMR) and Medical

Readiness Classification (MRC) and Dental Readiness Classification (DRC) in order to provide services to the NGDE

Soldiers. They must know particularly the requirements of dental readiness for the state of Delaware and be proficient with DENCLASS and MEDPROS. As mentioned in “1.3 Objectives and Scope,” all access to MODS modules will be performed by awarded vendor and NOT sub-contracted data entry by second or third-party entities. Certificates, licenses and/or qualifications must be submitted from the offeror with the proposals.

• HIPAA certificates (of all dentists, dental technicians, dental hygienists, data entry and/or admin assistants

• Privacy Act

• OSHA & ADA compliant

1.5.9 Special Qualifications: Individual case management and oversight by a dedicated Dental Director (licensed DDS or DMD). The Dental Director on staff is responsible for ensuring that all members are certified dental professionals with Delaware Licensure, as well as all dental staff working with each dentist. Dental assistants and staff shall be trained and professional with good morals and ethics.

1.5.10 Security Requirements: The contractor shall be responsible for safeguarding all government property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

It will be the responsibility of the awarded vendor to obtain CAC accessible computers for each site/event.

1.5.11 Contracting Officer Representatives (COR): The COR and alternate COR are identified below:

COR: MAJ Jason Brooks 302-326-7178, jason.t.brooks2.mil@army.mil

The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract:

perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry (or Medical Readiness NCO) of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.5.12: Medical Readiness Non-Commissioned Offices (MRNCO): The MRNCO shall serve as the principal point of scheduling and unit contact once the contract is executed through the Deputy State Surgeon. Beside the COR and Alt.

COR, this individual will serve as the only liaison to authorize an event location and to provide instructions to the contractor regarding event services. The MRNCO will not alter the services, add or defer from the existing “call” of the contract without express authorization of the Deputy State Surgeon or Alt. COR.

1.5.13 Contract Manager: The Contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract.

PART 2

DEFINITIONS & ACRONYMS

A. IMR – Individual Medical Readiness: is defined as being free oh health-related conditions that limit a

Soldier’s ability to actively fulfill his/her assigned mission. Individual Medical Readiness consists of six elements: Dental Readiness, Immunization Status, Periodic Health Assessment (PHA), No deployment limiting conditions, Medical Laboratory Tests, and Individual Medical Equipment.

B. MRC – Medical Readiness Classification - All categories of medical readiness including Dental Class.

C. DENCLASS – Dental Classification: An approved ARNG web-based module designed to standardize the court of dental classifications, eliminate duplicate data system entry, facilitate the dental exam workflow, standardize the documentation of the health history and record of dental exam and integrate dental readiness within the Medical Operational Data Systems (MODS) architecture. The DENCLASS module has been designed to document the dental readiness requirements of all ARNG Soldiers.

Components of DENCLASS include; an automated health history, an automated SF603A, an automated letter outlining the dental treatment plan, a repository for dental radiographs, a library of dental readiness policy and statistical reporting of all components of DENCLASS.

D. MEDPROS – Medical Protection System: The Medical Protection System (MEDPROS) was developed by the AMEDD to tract all immunizations, medical readiness and deployability data for all Active and

Reserve components of the Army as well as DA Civilians, contractors and others. The comprehensive

Medical Readiness data includes all medical and dental readiness requirements, IAW AR 600-8-101.

E. TMC –Troop Medical Clinic

F. ADA – American Dental Association

G. OSHA – Occupational Safety and Health Association

H. “Chair-side” dental classification – Examinations and culminating classification (and entry into

DENCLASS “real-time”) that occurs at the Soldier’s/patient’s chair-side; occurring at the actual time of the examination.

I. Organic staff – Staff who work for the selected vendor as primary staff; i.e. not sub-contracted staff.

J. Real-time – Events that occur as close to immediate to the actual events and/or same day.

K. An annual oral examination shall consist of routine exploratory identification according to DoD

Guidelines for a Periodic Oral Evaluation, American Dental Association (ADA) procedure code

D0120. This exam consists of

a. A clinical evaluation of the oral cavity supported by bitewings and panoramic x-ray.

b. Panographic and Supporting Radiograph Requirements:

(1) The frequency of prescribing radiographs is based upon the clinical judgment of the Soldier’s dentist and existing practice guidelines. (e.g. HHS Publication No.FDA 88-8273) Radiographs shall be of diagnostic quality, properly identified, dated and placed in the military dental record. A panographic radiograph of adequate quality for diagnostic and forensic identification purposes is required in the dental record. There is no time requirement on updating panographic radiographs. However, the panographic radiograph must adequately represent the current oral condition of the Soldier. Soldiers shall have a panographic x-ray taken during initial dental processing. A new panographic x-ray shall be taken after extensive dental treatment.

(2) Digital x-rays are acceptable if they are a JPEG file and can be printed approximately the size, resolution and diagnostic quality of a regular x-ray.

c. All required information must be entered correctly on SF 603/603A to expedite exam validation at MOB site.

L. MODS: The Medical Operational Data Systems is an objective system that provides the Army Medical

Department with an integrated automation that supports all phases of the Human Resource Life-Cycle

Management in both peacetime and mobilization. MODS currently maintains sixty system interfaces which are updated on a daily, weekly, monthly or semi-annual basis.

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3.1 GENERAL: Only parking will be provided for HIPAA, Privacy Act, OSHA & ADA-Compliant, Self-Contained

Portable Medical/Dental Practices. As stipulated in Section “1.2.1 PWS” of this document, the Offeror must able to be set up at 1 Vavala Way, New Castle DE 19720.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4.1 General: Except for those items specifically stated to be government furnished in Part 3, the contractor shall furnish everything required to perform this PWS.

4.2 Secret Facility Clearance: The Contractor shall possess or be eligible to receive and maintain a SECRET facility clearance from the Defense Security Service. The Contractor’s employees, performing work in support of this contract shall have been granted a SECRET security clearance from the Defense Industrial Security Clearance Office.

PART 5

SPECIFIC TASKS

5.1 SPECIFIC TASKS: The contractor shall provide customized comprehensive dental readiness services to include annual dental examinations, clinically indicated radiologic studies (bite-wing x-rays), and when clinically indicated, specified treatment outlined in the patient’s treatment plan. These services will take place in the NGDE HQ building using contractor owned equipment and supplies. Upon completion of services, medical information will be documented in accordance with Department of the Army Policy. Reports will be provided to the NGDE Deputy State

Surgeon’s Office. The contractor shall also ensure the requirements of Occupational Safety and Health Administration

(OSHA) and applicable federal regulations are met.

Anticipated Number of Soldiers:

Base: Saturday, 5 August = 85 Soldiers

Sunday, 6 August = 85 Soldiers

5.1.1 The awarded contractor will provide a detailed roster (and accompanying treatment plan for each known Class 3

Soldier – performed by the Dental Director) of each identified Soldier’s needs based upon information available in

DENCLASS and MEDPROS. Receipt of this final spreadsheet shall be sent to the Deputy State Surgeon no later than

2 days prior to the start of the event.

5.2. Exam. To be conducted when indicated and needed. A periodic oral evaluation shall assess the current state of oral health and risk for future dental disease as well as assessing general health factors that relate to the treatment of the patient. The following measures are required for each periodic oral evaluation:

5.2.1. Caries Risk Assessment – Classify Soldiers as low, moderate, or high risk for caries as described by the

American Dental Association’s 1995 Special Supplement. This assessment will allow the ADCS to identify those at high risk for future disease and appropriately manage their care.

5.2.2. Periodontal Assessment – Periodontal Screening and Recording (PSR), a screening procedure endorsed by the

American Dental Association and the American Academy of Period ontology, should be utilized to determine the need for periodontal treatment.

5.2.3. Tobacco Risk Assessment – Classify Soldiers as a smoker, user of smokeless tobacco, both or neither.

5.2.4. Oral Cancer Screening – Perform a thorough oral cancer screening as part of all examinations

5.2.5. Radiographs should be taken only for clinical reasons according to FDA guidelines as determined by the patient’s dentist. Radiographs should be of diagnostic quality, properly identified and dated. A panograph is required to be present in the dental record and that it is of adequate quality for diagnostic/identification purposes. There is no time requirement on updating panographic radiographs. However, the panographic radiograph will adequately represent the current oral condition of the Soldier.

5.3. Documentation. Documentation of exam and treatments shall be returned to the Delaware Army National Guard

Medical Representative (Deputy State Surgeon) from the Office of the State Surgeon. The Contractor will return all functional files maintained by the Contractor to the government upon completion of the required services.

5.4.1. SF 603/603A, Record of Dental Exam and treatment shall be completed.

5.4.2. Supporting Radiographs (pantograph/four bitewings) if necessary.

5.4.3. A diagnostic quality copy of all radiographs must be placed in the dental record as required.

PART 6

APPLICABLE PUBLICATIONS

6.1 Publications applicable to this PWS are listed below. The publications must be coded as mandatory or advisory, the date of the publication, and what chapters or pages are applicable to the requirement. All publications listed are available via the Internet at the specified e-mail address:

https://apps.mods.army.mil/MEDPROS/Secured/ and https://apps.mods.army.mil/denclass/

TECHNICAL EXHIBIT 1

Performance Requirements Summary

Specification Item Performance Objective AQL Method of

Surveillance

Sample

Size

Frequency

On-Location Dental

Treatment Services

Upgrade Soldiers to a Class 2 deployable status from Class 3a or 3b

97% Inspection 100% 100%

Sub-Contracted

Dental Treatment

Services

Upgrade Soldiers to a Class 2 deployable status regardless of status

100% Inspection 100% 100%

Dental Examinations Perform dental examinations in accordance with Army standards

100% Inspection 100% 100% https://apps.mods.army.mil/MEDPROS/Secured/ https://apps.mods.army.mil/denclass/

Documentation into

DENCLASS

Perform “real-time” and “chair-side” documentation into Army systems on-location

100% Inspection 100% 100%

APPENDIX A

Definitions of Dental Classifications:

a. Class 1: Patients with a current dental examination, who do not require dental treatment or reevaluation. Class 1 patients are worldwide deployable.

b. Class 2: Patients with current dental examination, which require non-urgent dental treatment or reevaluation for oral conditions, which are unlikely to result in dental emergencies within 12 months. Class 2 patients are worldwide deployable. Patients in dental class 2 may exhibit the following:

(1) Treatment or follow-up indicated for dental caries or minor defective restorations that can be maintained by the patient.

(2) Interim restorations or prosthesis that can be maintained for a 12 month period. This includes teeth that have been restored with permanent restorative materials for which protective cuspal coverage is indicated.

(3) Edentulous areas requiring prosthesis but not on an immediate basis.

(4) Periodontium that

(a) requires oral prophylaxis

(b) requires maintenance therapy

(c) requires treatment for slight to moderate periodontitis and stable cases of more advanced periodontitis.

(5) Unerupted, partially erupted or malposed teeth that are without historical, clinical or radiographic signs or symptoms of pathosis, but which are recommended for prophylactic removal.

(6) Active orthodontic treatment. The provider should consider placing the patient in passive appliances for deployment up to six months. For longer periods of deployment, the provider should consider removing active appliances and placing the patient in passive retention.

(7) Temporomandibular disorder patients in remission. The provider anticipates the patient can perform duties while deployed without ongoing care and any medications or appliances required for maintenance will not interfere with duties.

c. Class 3: Patients who require urgent or emergent dental treatment. Class 3 patients normally are not considered to be worldwide deployable.

(1) Treatment or follow-up indicated for dental caries, symptomatic tooth fracture or defective restorations that cannot be maintained by the patient.

(2) Interim restorations or prostheses that cannot be maintained for a 12 month period.

(3) Patients requiring treatment for the following periodontal conditions that may result in dental emergencies within the next 12 months.

(a) Edentulous areas or teeth requiring immediate prosthodontic treatment for adequate mastication or communication or acceptable esthetics.

(b) Active progressive moderate or advanced periodontitis

(c) Periodontal abscesses

(d) Progressive mucogingival condition

(e) Periodontal manifestations of systemic disease or hormonal disturbances

(f) Heavy subgingival calculus

(4) Edentulous areas or teeth requiring immediate prosthodontic treatment for adequate mastication or communication or acceptable esthetics.

(5) Unerupted, partially erupted or malposed teeth with historical, clinical or radiographic signs or symptoms of pathosis that are recommended for removal.

(6) Chronic oral infections or other pathologic lesions including:

(a) Pulpal, periapical or resorptive pathology requiring treatment.

(b) Lesions requiring biopsy or awaiting biopsy report.

(7) Emergency situations requiring therapy to relieve pain, treat trauma, treat acute oral infections or provide timely follow-up care (e.g., drain or suture removal until resolved.)

(8) Acute temporomandibular disorders requiring active treatment that may interfere with duties.

d. Class 4: Patients who require periodontic dental examinations or patients with unknown dental classifications. Class

4 patients normally are not considered to be worldwide deployable.