CAARNG Medical Surveillance PWS_FINAL 24 Aug 26.pdf

PERFORMANCE WORK STATEMENT(PWS) FOR

Occupational Medical Examination and Laboratory Services

24 August 2026

1.0 General: This requirement is for non-personal health care services contract to perform Occupational Health Medical Surveillance Exams and Laboratory Support Services in accordance with the Occupational Safety and Health Administration (OSHA) and other Department of Defense (DoD) regulations. The contractor(s) will be required to provide preplacement, baseline, periodic, fit for duty, exposure, respiratory medical clearance and exit exams as required by OSHA law and DoD regulation to Federal Employees of the CAARNG. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. The key personnel selected for contract service shall be accountable solely to the Contractor who, in turn is responsible to the Government. The Government will evaluate the quality of high level professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered.

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary to perform Federal Employee Medical Surveillance Examination and laboratory Services, as defined in this PWS. The contractor(s) is to work with the CAARNG Occupational Health Office (CAOHO) and its staff to develop a screening plan, coordinate schedules of exams and provide results for each employee identified and enrolled in Medical Surveillance IAW 29 CFR 1910 and DoDI 6055.05M and facilitate the implementation and the progress toward the established plan.

1.1.1 Objectives: Contractor(s) shall conduct all portions of exams and laboratory services for federal employees on day of appointment between the times of 7:00 a.m.

through 4:00 p.m.

1.2 Background: The Occupational Medical Examination and Laboratory Services is a statutory federal requirement to monitor the health of federal employees exposed to toxic workplace hazards utilizing Occupational Medical Examinations and Laboratory Services. The exams will be given to an estimated 275 CAARNG federal employees annually identified by the CAOHO. The number of projected federal employees to be tested may change due to military related obligations. The contractor shall only charge per test and quantity of services rendered. Invoicing is by CLIN number based on the number of tests completed.

1.3 Period of Performance (PoP): The Period of Performance shall be 1 Base Year of 12 months and four (4) 12-month option years.

1.4 General Information:

1.4.1 Place and Performance of Services: The contractor shall provide services between the hours of 7:00 am through 4:00pm, Monday-Friday, 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 shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the contractor should keep in mind that the stability and continuity of the work force are essential. Below are the recommended zones provided by CAOHO. The requirement is at least one clinic per zone (North, East, West, and South), located in one of the CA counties within that zone, at a minimum, will be required to perform the services required under this contract.

Zones by CA County for clinics Zone 1 (North)

Zone 2 (East)

Zone 3 (West)

Zone 4 (Sout

1.4.2 Recognized Holidays: The following are recognized United States (US) holidays.

The contractor shall not perform services on these days:

1.4.2.1 New Year’s Day

1.4.2.2 Martin Luther King, Jr.’s Birthday

1.4.2.3 President’s Day

1.4.2.4 Memorial Day

1.4.2.5 Juneteenth National Independence Day

1.4.2.6 Independence Day

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.9 Veteran’s Day

1.4.2.10 Thanksgiving Day

1.4.2.11 Christmas Day

1.4.3 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is how it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary (PRS). A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after the contract award. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

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

1.4.5 Special Qualifications: Special Qualifications: The contractor shall ensure all employees possess license, certification, or registry in accordance with applicable State laws and regulations to perform physical examinations 49 CFR § 391.43 – Medical Examination; Certificate of Physical Examination. Providers must be trained in or have experience with occupational medicine to conduct job-related medical surveillance examinations. All contracted personnel must be informed and knowledgeable on DoD 6055.05M and OSHA Standards that relate to respective exams of hazard exposures.

Those performing audiograms must be certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC) or who has satisfactorily demonstrated competences in administering audiometric examinations. Those performing spirometry testing must be certified through an approved NIOSH training course. Those performing laboratory functions such as blood draws, and urine collection must be certified through American Society for Clinical Pathology (ASCP). This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information. This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information.

(NOTE: The Government does not provide training to contractors. Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified, and otherwise qualified to provide services.)

1.4.6 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 appraise the contractor of how the Government views the contractor’s performance and the contractor appraises the Government of problems, if any, being experienced.

The contractor shall resolve the outstanding issues raised by the Government.

Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.7 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 the 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 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.

1.4.8 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 should 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 wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed.

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

1.4.10 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.

1.4.11 Contractor Travel

The contractor shall travel or provide services to specific locations within California during the performance of this contract to perform Occupational Medical and Laboratory Services. The contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires COR recommendation for approval and/or authorization by the KO prior to travel arrangements being made.

1.4.12 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 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.

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 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 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 people 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 a contract with a prime contractor. The Government does not have a contract with the subcontractor.

2.2 Acronyms:

ADA Americans with Disabilities Act AEI Army Enterprise Info structure AR Army Regulation As Arsenic ASCP American Society for Clinical Pathology AT/OPSEC Antiterrorism/Operational Security BI Background Investigation CAOHC Council for Accreditation in Occupational Hearing Conservation CAOHN California Occupational Health Nurse

CAOHO California Occupational Health Office CBC with Diff Complete Blood Count with Differential Cd Cadmium CM Contract Manager CMP Comprehensive Metabolic Panel COR Contracting Officer Representative DA Department of the Army DD254 Department of Defense Contract Security Classification Specification DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services Hg Mercury H&P History, physical and mental information that would affect work HIPPA Health Insurance portability and Accountability Act HQDA Headquarters, Department of the Army HSPD Homeland Security Presidential Directive HSS Health System Services IA Information Assurance IS Information System(s) IMR Individual Medical Requirements JFHQ Joint Forces Headquarters KO Contracting Officer MEDPROS Medical Protection System MODS Medical Operational Data System NGB National Guard Bureau NIOSH National Institute for Occupational Safety and Health OCI Organizational Conflict of Interest OHN Occupational Health Nurse OSHA Occupational Safety and Health Administration Pb Lead PFT Pulmonary Function Test PII Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program SCR Service Contract Reporting SSN Social Security Number TE Technical Exhibit USD (I) Under Secretary of Defense for Intelligence ZPP 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: None

3.1 Materials: None

3.2 Equipment: None

3.3 Services: None

3.4 Utilities: All utilities in the facility will be available for the contactors’ use in the performance of this contract. The contractor shall instruct employees in utilities conservation and safe use 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: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

4.3 Contractor Security Clearance: None

5.0 Requirements: The contractor shall:

5.1 The contractor shall provide all management. Labor, material, equipment, certifications and supplies necessary to provide all listed services. The contractor shall be a business entity of the sort that can legally exercise ownership and/or control of persons/employees that are licensed/registered and credentialed to practice medicine and/or conduct physical examinations in accordance with all legal and regulatory requirements in the State of California.

5.1.1 The contractor shall ensure that the provider has a facility with an exam room.

The contract provider will have the appropriate tables, exam equipment, and supplies available to conduct a thorough exam according to Occupational Medical Surveillance standards per job code and description. The contractor's provider’s clinics or laboratory workplaces must be sanitary, orderly and neat in appearance, abiding by good infection control practices.

5.1.2 Contractor's instrumentation shall meet or exceed appropriate performance standards and accuracy must be verified IAW current Occupational Medicine Certification standards. In the event of the Contractor’s equipment failure, specific testing and/or parts of examinations that are not completed during the testing period shall be completed at a scheduled time mutually convenient for the Contractor and the CAARNG. Unfinished testing/examinations will be completed at no additional cost to the Government. The Contractor shall be directly responsible to cover costs for completing these examinations.

5.1.3 Contractor shall ensure each healthcare worker complies with Federal, State of California, local laws as well as OSHA Law & Regulations 29 CFR 1910.

5.1.4 The contractor shall provide preplacement, baseline, periodic, fit for duty, exposure, respiratory medical clearance and exit exams as required by OSH Act of 1970. The contractor shall be compliant with ADA, ASCP, HIPAA, NIOSH, OSHA, and Privacy Act. Medical written clearance shall be provided in the memorandum format on the Clinic’s letterhead. CAOHO will provide the list of service exams by job function to the contractor.

5.1.5 The contractor shall provide the following services: Physical exams; Standard Components Series: Height & Weight, Vital Signs, & Audiogram; Vision/Ocular Testing:

Vision, Color vision, Depth Perception and Field of Vision & Labs. See 5.1.5.1 for a more comprehensive list of services to be provided. The CAOHO will provide a field of work and name of individuals scheduled for exams to determine what tests are to be processed. Medical exam components are listed below.

5.1.5.1 The contractor shall perform an Exam on every federal employee which shall consist of some or all of the following exam components:

CLIN TESTS/ EXAM Standard Components Series

Quantity (Estimate) Number of Tests/Exams per year

0001 Scheduling 275

0002 Complete Medical Exam & QA 275

0003 Audiogram 50

0004 Venipuncture 75

0005 Blood Lead/ZPP 75

0006 Blood Cadmium 46

0007 Blood Chromium 13

0008 PFT 85

0009 Respiratory Clearance 85

0010 Respiratory Fit Test 85

5.1.5.2 Initial Coordination: The contractor will make appointments for federal employees. CAOHO shall also provide a written authorization to request exams and inform the contractor of each exam component and test. Any applicable job descriptions, medical history, or questionnaires(s) will be provided by CAOHO to the clinic after coordination of appointments. Federal employees who fail to report to scheduled appointments will be reported to CAOHO immediately. Rescheduling appointments shall be made through CAOHO.

5.1.5.3 The Contractor shall indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance. The Contractor is required to ensure that its subcontractors, if any, for provisions of health care services, contain the requirements of the FAR 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance as prescribed in FAR 37.403 contract clause. Contractor shall ensure all clinical laboratory/chemistry 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.

5.1.5.4 The Contractor will inform patients on exam and test findings and provide wellness education.

5.1.6 Exam Scheduling with CAOHO The contractor shall coordinate with CAOHO, and alert said office of missed appointments.

5.2 The Contractor shall notify CAOHO of any abnormal clinical findings on specimens that indicate the possibility of a present danger to the employee. These results will be reported within 24 hours, not to exceed 72 hours to the CAOHO at 916- 854-1422 and via email to the COR. If abnormal findings are due to a contractor error, the exam will be repeated at no additional charge.

5.2.1 The contractor shall notify the employee both verbally, and in writing, (within 7 days) if there is abnormality in the exam or laboratory results and recommended medical follow-up. Any non-work-related abnormality should include written recommendations for follow-up.

5.3 Complete written reports and diagnostic testing results will be administratively organized and provided to the CAOHO via electronic portal. Electronic medical results will be posted within 30 days of the post event, results will be available for the entire contract period and within 365 days after the end of contract. The contractor shall present reports for PFTs that include both graph and data IAW National Health and Nutrition Examination Survey III (NHANES III) Reference Values. Any excel spreadsheets of results, respirator clearances, heavy metal clearances abnormal findings, hearing results with STS and OSHA reportable/recordable notification, with those that need follow-ups, any medical limitations from the functional capacity exam.

Access to the repository will be made available to the COR within 30 days of contract award.

The Contractor shall report the required information annually by October 31, for services performed under this contract during the preceding Government fiscal year (October 1- September 30).

The DoD Guidebook for Service Contract Reporting in SAM, available on the DoD Procurement Toolbox at https://dodprocurementtoolbox.com/site-pages/service-contract-reporting-scr. The General Services Administration (GSA) has also posted additional guidance such as quick start guides, informational videos, and frequently asked questions, that can be accessed by going to https://sam.gov and searching the “HELP” section. The SAM Federal User Guide is also available in the “HELP” section for comprehensive instructions on navigating SAM. Contractors requiring assistance using SAM should contact the Federal Service Desk at https://www.fsd.gov.

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

Publication (Chapter/Page)

Date of Publication

Mandato ry or Advisory

Website

29 CFR 1910.1030,

Bloodborne Pathogens

18 January

Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1

29 CFR 1960, Federal Employee

Occupational Safety & Health Programs

5 July 1995 Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1960

5 CFR 339, Medical Qualification Determinations for Federal Employees

18 Jan 2017 Mandatory https://www.law.cornell.edu/cfr/text/5/part-339

5 CFR 293, Federal Employee Medical File System

9 Nov 1979 Mandatory https://www.law.cornell.edu/cfr/text/5/293.504

DoDI 6055.1, Safety & Occupational

Health Program (SOH)

14/10/2014 Mandatory https://www.esd.whs.mil/Portals/54/Documents/ DD/is suances/dodi/605501p.pdf

DoDI 6055.05M, DoD Medical Surveillance Program

11/11/2008 with change 08/31/2018

Mandatory https://www.esd.whs.mil/Portals/54/Docume nts/DD/is suances/dodi/605505p.pdf?ver=2017-11-21-

114053-

DA Pam 40-501, The Army Hearing Program

1/08/2015 Mandatory https://phc.amedd.army.mil/topics/workplacehea lth/hrc

/Pages/Hearing-Conservation-(HC).aspx http://www.osha.gov/laws-http://www.osha.gov/laws-http://www.law.cornell.edu/cfr/text/5/part-339 http://www.law.cornell.edu/cfr/text/5/293.504 http://www.esd.whs.mil/Portals/54/Documents/DD/is http://www.esd.whs.mil/Portals/54/Documents/DD/is http://www.esd.whs.mil/Portals/54/Documents/DD/is http://www.esd.whs.mil/Portals/54/Documents/DD/is

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).

ATTACHMENT 1:

PERFORMANCE

REQUIREMENTS

SUMMARY (PRS)

Performance Objective

Performance Standard

Acceptable Quality Levels (AQL)

Surveillance Method / By Whom

5.1 Contractor personnel

The contractor shall provide all management for provider and personnel performing exams.

Provide employees that are properly licensed and registered to perform needed exams.

Periodic Inspection

/ COR

5.1.1 Medical Exam(s) Facility

The contractor shall ensure the provider has an adequate facility for exams that meet IAW with federal regulations.

Provide a sanitary, orderly, and neat appearance facility with exam space, tables, equipment, and supplies.

Periodic Inspection

/ COR

5.1.5 Medical Surveillance Exam requirements

The contractor shall perform occupational medical surveillance examinations IAW with federal regulations.

Provide all services in accordance with DoD & OSHA Regulations, and Job description with no more than 5% error rate annually.

Periodic Inspection

/ COR

5.1.6 Exam Scheduling with TOHO

The contractor shall coordinate with CAOHO, and alert said office of missed appointments.

Errors in notification reporting should be no more than 5%.

Random monitoring

/ COR

5.2 Contractor Notification of

The contractor shall notify TOHO immediately, within

Notification reporting should be accurate and timely

Random monitoring

/ COR

Health Risk Findings to TOHO

24 to 72 hours, when results are received that may present a health risk to the federal employee.

with no more than 3% errors.

5.2.1 Written Reports Exam Result Reporting to TOHO

The contractor shall provide all exams, and diagnostic test results electronically or in writing within 7 days of the exam. Results to Occupational Health.

Errors in notification reporting should be no more than 5%.

Random monitoring

/ COR