B08_Attach-1_PWS_9Apr2024.pdf

U.S. ARMY CORPS OF ENGINEERS

FORT WORTH DISTRICT

PINEY WOODS PROJECTS

PERFORMANCE WORK STATEMENT (PWS) FOR

MEDICAL SURVELLIANCE

1. GENERAL: This is a non-personal services contract to provide medical surveillance for Piney Woods region, (Sam Rayburn/ Town Bluff Projects, Jasper/Woodville, Texas; Lake O’ the Pines, Jefferson, Texas; Lake Wright Patman, Texarkana, Texas; and Jim Chapman Lake, Sulphur Springs, Texas.) The Government shall not exercise any supervision or control over the contract service providers. The contract service providers shall be accountable to the Contractor (KTR), who in turn is responsible to the Government.

1.1 DESCRIPTION OF SERVICES/INTRODUCTION: The Contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, supervision, and any other items necessary to effectively perform medical testing services as defined in this Performance Work Statement with the exception of those items specified as government furnished property and services. The Contractor shall perform to the current existing medical standards in this contract.

1.2. SCOPE: The Contractor shall perform medical testing for employees at Piney Woods Projects.

Contractor will provide an on-site mobile unit that can meet the requirements below and provide the medical surveillance with minimal disruption of the workers day.

1.2.1 Medical history questionnaire

1.2.1.1 Provide medical history questionnaire to each employee who will be tested. This questionnaire should be provided prior to the testing date. Each employee will provide the completed questionnaire at the time of testing.

1.2.2 Physician Examination

1.2.2.1 Using a licensed physician or Nurse Practitioner to perform exams for each designated employee. Examinations will be performed in a private examining room, according to standard protocol.

Examining physician will inform employee of any serious findings that need immediate medical attention, but will not initiate any diagnosis, treatment, or prescription.

1.2.3 Physical & Vital Measurements

1.2.3.1 Employee’s height, weight, blood pressure and pulse rate will be measured and recorded.

1.2.4 Laboratory Tests

1.2.4.1 Prior to testing date provide each designated employee with container (with instructions) for collection of random urine specimen. On morning of employee testing, employee will provide urine sample in the provided container at which time phlebotomy technician will perform necessary blood draw. Laboratory tests listed below will be performed by a CLIA and CAP certified laboratory. Quality and accuracy of the tests will be of highest quality, equivalent to that of a hospital environment.

1. Blood Chemistry (SMAC)

a. Calcium k. Glucose

b. Creatinine l. Alkaline Phosphatase

c. Total Bilirubin m. SGOT

d. Albumin n. SGPT

e. Total Protein o. Cholesterol

f. Iron p. HDL Cholesterol

g. Blood Urea Nitrogen q. LDL Cholesterol

h. Sodium r. Triglycerides

i. Potassium s. PSA

j. Chloride t. Thyroid

2. Hematology (CBC)

a. White Blood Count g. MCHC

b. Red Blood Count h. Lymphocytes

c. Hemoglobin i. Monocytes

d. Hematocrit j. Eosinophils

e. MCV k. Basophils

f. MCH l. Platelet Count

m. A1c

3. Urinalysis

a. Color h. Sugar

b. Character i. Ketones

c. Specific Gravity j. Bilirubin

d. PH k. Blood

e. Protein l. Urobilinogen

f. Nitrite m. Microscopic analysis (abnormal)

g. Leukocyte Esterase

1.2.5 Electrocardiogram

1.2.5.1 A resting 12-lead electrocardiogram with self-interpretation will be performed and recorded by a trained ECG technician for each designated employee. All ECGs with other than normal interpretation will be reviewed by a board-certified cardiologist for a nominal fee. As with all other tests, any findings requiring immediate attention will be directed to the Fort Worth District Industrial Hygienist

1.2.6 Audiometry (hearing)

1.2.6.1 Hearing evaluation will be performed using pure tone air conduction testing at six frequencies: 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hertz (HZ) Testing will be conducted in sound attenuation rooms under the direction of a certified audiology technician. Instruments will be computer controlled to eliminate variables and calibrated to ANSI 69 standards. With previous baseline information separate computer analysis of the audiograms can be generated for a nominal fee with special emphasis on the following categories:

OSHA Standard Threshold Shift Audiological Significant Noise and/or Medical Shifts Baseline Audiograms Demonstrating Hearing Loss Revised Baselines Due to Improvement in Hearing Potentially Recordable Hearing Losses

1.2.7 Spirometry (Pulmonary) Function Test

1.2.7.1 Using a spirometer attached directly to a microprocessor for immediate measurement and verification a certified pulmonary technician shall administer this test in which the employee performs three deep-breath efforts with the best measurement being recorded. These results will be compared to the Knudson norms, as specified by the NIOSH Cotton Dust Standards, and include ratios of:

Peak Expired Flow Rate (PEFR) Forced Vital Capacity (FVC) Forced Expired Volume at 1 second. (FEV-1) Forced Expired Volume at 3 seconds (FEV-3) Ration of (FEV-1/FFVC) Predicted

1.2.8 Chest X-Ray

1.2.8.1 A 14x17 view of the chest will be taken for each designated employee. The films will be taken for each employee. The films will be processed at the testing facility before the employee leaves. If necessary, any repeat x-rays can be taken while the employee is still present. All films will be interpreted by a board-certified radiologist.

1.2.9 Vision Testing

1.2.9.1 Vision testing will be performed by a technician trained in the use of a Titmus vision screening instrument. The tests will consist of the following:

Visual Acuity-distant (corrected and uncorrected) Horizontal Testing Color Perception Depth Perception

1.2.12 Health Profile Report

1.2.12.1 All data collected in the testing program will be computer processed and printed on the health testing report. The report will be formatted so that up to five years of data for each test can be sequentially displayed across the page providing and easy comparison to previous test data. The back page of the report will contain an out-of-range results summary section designed for quick review by a physician of all test findings which will be specifically noted. This data will identify in the body of the report by one or two asterisks of “H” (high) or “L” (low) designation. All the test results will be accompanied by a set of reference values, derived from published and medically accepted tables or from extensive experience of the medical screening lab. The completed health reports along with all the raw data will be presented to the Fort Worth District Industrial Hygienist within 21-28 working days from the final date of testing. All HIPAA requirements should be included and followed.

1.2.12.2 The Contractor shall provide DOT/Crane operator physicals for team members with CDL’s and personnel operating overhead cranes. Certificates shall be provided for these team members.

1.2.13 Responsibility of the Corps of Engineers

1.2.13.1 The Corps of Engineers will furnish to the contractor a list (approximately 28) of the employees designated for testing which will include the employees’ full name, employee identification number, date of birth and gender. The Corps of Engineers will designate a suitable location and electrical supply for the contractor’s mobile testing unit during the testing.

1.3 SAFETY REQUIREMENTS: The Contractor shall perform all services in full compliance with the safety requirements set forth in the current EM 385-1-1, entitled "Safety and Health Requirements Manual", which is available at the Project Office and at http://www.hq.usace.army.mil (select Safety; and Occupational Health). Consequently, the Contractor shall be responsible for complying with the current edition and all changes posted on the web as of the effective date of this solicitation.

http://www.hq.usace.army.mil/

1.4 PERIOD OF PERFORMANCE: 3 June 2024 through 2 June 2025 (plus four option periods)

1.5 WORKDAY: Work shall commence no sooner than 8:00 a.m. Services must be completed by 6:00 p.m. unless a different time is authorized in advance by Corps of Engineers personnel.

1.6 GENERAL INFORMATION:

1.6.1. CONTRACTOR QUALITY CONTROL: The Contractor is responsible for establishing and maintaining an adequate QC system to satisfactorily inspect and ensure that all work performed by the Contractor’s organization in each separate service is in full compliance with this contract and the instructions, provisions, specifications, and maps herein. The Contractor shall designate, in writing, a QC Inspector, whose main duty shall be to verify contract conformance of all work performed and to notify the Government Point of Contact (Government Quality Assurance Representative or Contracting Officer) of anything requiring immediate attention.

1.6.2 CONTRACTOR QUALITY CONTROL PLAN: Contractor Quality Control will be assured by a detailed Quality Control Plan developed by the Contractor and submitted to the Government Point of Contact for approval at the “Pre-work conference” scheduled for approximately ten (10) days prior to beginning any services required by this contract. The Government will monitor and inspect the Contractor’s operation to ensure that the Quality Control Plan is in place and is working, and that the Contractor’s performance meets all contract specifications.

1.6.3 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 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). The Government reserves the right to alter or change the type of inspection plan at its discretion at any time, and to make deductions accordingly.

1.6.3.1 GENERAL: The Government Point of Contact will inspect the work in each area as it is completed to ensure all requirements of the contract have been satisfied. The Contractor QCR will be responsible to ensure all work is completed prior to inspection by the Government.

1.6.3.2. PERFORMANCE EVALUATION MEETINGS: The Contractor, his superintendent, QC inspector, or all, shall meet with the Government Point of Contact, periodically as determined necessary by the Government Point of Contact, in order to discuss performance. However, a meeting shall be held not later than one normal workday after a Contract Deficiency Report (CDR) is issued. Mutual effort will be made to resolve any and all problems identified.

1.6.4 GOVERNMENT HOLIDAYS: The Contractor is not required to perform services on Federal Holidays. Government Holidays are listed below:

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Juneteenth Christmas Day Independence Day

1.6.5 HOURS OF OPERATION: Piney woods Project office hours are Monday through Friday, 8:00 am to 4:30 pm.

1.6.6. PLACE OF PERFORMANCE: The work to be performed under this agreement will be performed at Sam Rayburn Project Office, located in Jasper County at 7696 Sam Rayburn Parkway, Jasper, Texas, 75951, Lake O’ the Pines located in Marion County at 2669 FM 726, Jefferson Texas, 75657, and Contractor provided facility.

1.6.6 TYPE OF CONTRACT: The government will award a Firm Fixed Price contract.

1.6.7 ANTITERRORISM/OPERATION SECURITY REQUIREMENTS:

1.6.7.1.1 AT General security requirements and guidance (DoD Components Only): The security requirements described below apply to all contract personnel (including employees of the prime Contractor (“Contractor”) and all subcontractor employees) supporting the performance requirements of this contract. The Contractor is responsible for compliance with these security requirements. Questions regarding security matters shall be addressed to the designated Government representative (e.g., Contracting Officer Representative (COR), Requiring Activity (RA) representative, or Contracting Officer (if a COR or other RA representative is not appointed)). The Department of Defense (DoD) and Service-specific security requirements specified below, if applicable, are performance requirements. All contract personnel shall complete applicable initial training within 30 days of contract award, or the date new contract personnel begin performance on the contract. The Contractor shall maintain security training records in accordance with applicable RA policies. Contractor personnel and vehicles are subject to search when entering federal installations. Additionally, all contract personnel shall comply with Force Protection Condition (FPCON) measures, Random Antiterrorism Measures (commonly referred to as “RAMs”), and Health Protection Condition (HPCON) measures. The Contractor is responsible for meeting performance requirements during elevated security in accordance with applicable RA plans and procedures—this includes identifying mission essential and non-mission essential personnel. In addition to the changes otherwise authorized by the changes clause of this contract, should the FPCON or HPCON levels at any individual facility or installation change, the Government may implement security changes that affect contract personnel. The Contractor shall ensure all contract personnel are aware of their security responsibilities, including any site-specific requirements identified in local policies or procedures.

1.6.7.1.2 Physical security and access control requirements (DoD Components Only): All contract personnel requiring physical access to a DoD installation or facility shall comply with the access control procedures of that location. Contract personnel requiring unescorted access on a DoD installation in the US to meet contract performance requirements shall be vetted by the installation/facility Provost Marshal/Directorate of Emergency Services/Security Office using the National Crime Information Center-Interstate Identification Index (commonly referred to as “NCIC-III”) and Terrorist Screening Database (commonly referred to as “TSDB”). Contract personnel shall comply with all personal identity verification requirements specified in installation/facility policies and procedures. Contract personnel who do not meet requirements for unescorted access to DoD-owned facilities shall coordinate escorted access with the Government representative, as needed. Contract personnel who receive keys, access cards, or lock combinations that provide access to government-owned property shall comply with key and lock control procedures of the RA. Reference: DoDM 5200.08, Volume 3, “Physical Security Program: Access to DoD Installations.”

1.6.7.1.3 Suspicious Activity Reporting Training (e.g. iWATCH. CorpsWatch, or See

Something, Say Something: All contract personnel shall receive initial and annual refresher training from the RA representative on the local suspicious activity reporting program. This locally developed training provides contract personnel with general information on suspicious behavior, and guidance on reporting suspicious activity to the project manager, security representative or law enforcement entity.

1.6.7.1.4 Escorting in classified and/or sensitive areas: In accordance with RA policies and procedures, all contract personnel who do not possess the appropriate security clearance or access privileges will be escorted in areas where they may be exposed to classified information or operations, sensitive information or activities, or other restricted areas.

1.6.7.1.5 Pre-screen candidates using E-Verify Program: Contractors shall comply with the requirements set forth in FAR clause 52.222-54 Employment Eligibility Verification and FAR Subpart

22.18 in using the E-Verify Program at (https://www.e-verify.gov/ ) (website subject to change) to meet the contract employment eligibility requirements. Contractors are encouraged to cooperate with Federal and State agencies responsible for enforcing labor requirements to include eligibility for employment under United States immigration laws in accordance with FAR 22.102-1(i). An initial list of verified/eligible candidates shall be provided to the RA’s COR or similar point of contact no later than three business days after the initial contract award. When contracts are with individuals, the individuals will be required to complete a Form I-9, Employment Eligibility Verification, and submit it to the Contracting Officer to become part of the official contract file.

1.6.8 POST AWARD CONFERENCE/PERIODIC PROGRESS MEETINGS: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The Contracting Officer, the Government Quality Assurance Representative (GQAR), and/or other Government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor's performance. At these meetings the Contracting Officer will apprise the Contractor of how the Government views the Contractor's performance and the Contractor will apprise the Government of problems, if any, being experienced.

Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the Government.

1.6.9. CONTRACTOR KEY PERSONNEL: The following personnel are considered key personnel by the Government: MD or Nurse Practitioner The Contractor shall provide a MD or Nurse Practitioner 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 MD or Nurse Practitioner is absent shall be designated in writing to the Contracting Officer. The MD or Nurse Practitioner or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract.

1.6.10. PAYMENT: Payment will be a one-time payment due after all requirements have been met.

1.7 FREQUENCY OF SERVICE:

1.7.1 YEARLY SERVICE: This is a one-time per year contract to be performed as near as possible to one year after the prior testing from the date of contract award. Once a year on site at Sam Rayburn project office, once a year at Lake O’ the Pines project office and provide a location within a fifty-mile radius of Sam Rayburn and Lake O’ the Pines for individuals that require testing outside of the annual sequence.

1.8 GOVERNMENT FURNISHED ITEMS AND SERVICES: No Government facilities, equipment, storage space or materials shall be provided to the Contractor for performance of this contract.

https://www.e-verify.gov/

1.9 CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

1.9.7 GENERAL: The Contractor shall furnish all supplies, equipment, facilities, and services required to perform work under this contract.

1.10 CONTRACTOR APPAREL REQUIREMENTS: Contractor and/or employees shall be appropriately dressed during performance of all services performed under this contract. Each person performing services shall wear a commercially manufactured name tag on the left breast pocket of clothing. See EM 385-1-1, Section 5, for additional restrictions on clothing.

1.11 INSURANCE:

1.11.1 REQUIREMENT: IAW FAR 52.228-5. Prior to commencement of work, the Contractor shall furnish the original Insurance Certificate directly to the Contracting Officer, Fort Worth District, Corps of Engineers, ATTN: CESWF-CT-S, P.O. Box 17300, Fort Worth, Texas 76102-0300 and one copy directly to the Area or Project Office. The Contractor shall maintain, during the entire period of his performance under this contract, the following minimum insurance requirements:

1.11.2 LIABILITY: Comprehensive general liability insurance for bodily injury in the minimum limits of $500,000 per occurrence. No property damage liability is required.

1.11.3 AUTOMOBILE: Comprehensive automobile liability insurance covering the operation of all automobiles used in connection with the performance of the contract in the minimum limits of $200,000 per person and $100,000 per accident for bodily injury and $20,000 per accident for property damage.

1.11.4 WORKERS COMPENSATION: Workmen's Compensation and Employer's Liability Insurance in the minimum amount of $100,000.00, or in compliance with applicable State statutes.

1.12 ENDORSEMENT: An endorsement to the effect that any cancellation or any material change adversely affecting the Government's interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer.

NOTE - It is recommended that the Contractor furnish a copy of the foregoing requirements to the insurance company in order to assure that an Insurance Certificate is issued meeting the minimum requirements shown. The Insurance Certificate shall also show the contract number to which it applies as well as a brief description and location of the work.

1.13 ATTACHMENT/TECHNICAL EXHIBIT LIST:

1.13.1 Attachment 1/Technical Exhibit 1 - Performance Requirements Summary

1.13.2 Attachment 2/Technical Exhibit 2 - Deliverable Schedule

Attachment 1

TECHNICAL EXHIBIT 1

Performance Requirements Summary

Performance Objective (The Service required—usually a shall statement)

Standard Performance Threshold (This is the maximum error rate. It could possibly be “Zero deviation from standard”)

Method of Surveillance

PRS # 1.

The contractor shall provide a questionnaire to each employee.

The contractor provided questionnaire as per PWS 1.2.1.1

Zero deviation from standard 100% Inspection

PRS # 2.

The contractor shall provide a physician exam of each employee.

The contractor provided physician exams to the specifications in PWS paragraph 1.2.2.1

Zero deviation from standard 100% Inspection

PRS # 3.

The contractor shall provide Physical & Vital measurements.

The contractor provided Physical & Vital Measurements per PWS 1.2.3.1

Zero deviation from standard 100% Inspection

PRS # 4.

The contractor shall provide laboratory tests for each employee.

The contractor provided laboratory as per PSW 1.2.4.1

Zero deviation from standard 100% Inspection

PRS # 5.

The contractor shall provide an Electrocardiogram for each employee.

The contractor provided electrocardiogram as per PWS 1.2.5.1

Zero deviation from standard 100% Inspection

PRS # 6.

The contractor shall provide an Audiometry exam for each employee.

The contractor provided audiometry exam as per PWS 1.2.6.1

Zero deviation from standard 100% Inspection

PRS # 7.

The contractor shall provide Spirometry exam for each employee.

The contractor provided spirometry test as per PWS 1.2.7.1

Zero deviation from standard 100% Inspection

PRS # 8.

The contractor shall provide chest X- ray for each employee.

The contractor provided chest X-ray as per PWS 1.2.8.1

Zero deviation from standard 100% Inspection

PRS # 9.

The contractor shall provide vision testing for each employee.

The contractor provided vision testing as per PWS 1.2.9.1

Zero deviation from standard 100% Inspection

PRS # 12.

The contractor shall provide Health Profile Report for each employee.

The contractor provided health profile report as per PWS 1.2.10.1

Zero deviation from standard 100% Inspection

Attachment 2

TECHNICAL EXHIBIT 2

DELIVERABLES SCHEDULE

Deliverable Frequency # of Copies Medium/Format Submit To Contractor shall provide medical history questionnaire to each employee.

PWS 1.2.1.1

Prior to testing date One copy per employee.

Hard copy. Appropriate Project Office.

Contractor shall provide urine sample container PWS 1.2.4.1

Day of testing One per employee tube Testing employee.

Contractor shall provide Health Profile Report PWS 1.2.10.1

21-28 days from date of testing

One copy per employee.

Hard copy. Fort Worth District Office Safety Manager.