Draft Performance Work Statement PHA Event April-May 2021.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

Physical Health Assessment (PHA) Services

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary except as specified in Paragraph 3.0 as Government Furnished, to perform PHA Non-Personal Services.

1.2 Background: The basic principles of force-sustainment for Nevada Army National Guard (NVARNG) include physical readiness which translates to mobility readiness. The subject contract will cover PHA events, which are based on soldiers being Individual Medial Readiness (IMR) and Fully Medically Ready

(FMR).

1.3 Period of Performance (PoP): The Period of Performance shall be April 10-11 2021 and May 1 2021.

1.4 General Information:

1.4.1 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 the means by which 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 contract award. A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after 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.

1.4.2 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).

1.4.3 Recognized Holidays: The following are recognized United States (US) holidays. The contractor shall not perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King, Jr.’s Birthday

1.4.3.3 President’s Day

1.4.3.4 Memorial Day

1.4.3.5 Independence Day: July 4th

1.4.3.6 Labor Day

1.4.3.7 Columbus Day

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day

1.4.3.10 Christmas Day: December 25th

1.4.4 Place and Performance of Services: The contractor shall provide services at events as scheduled; the events generally begin at 0700-0730 and run until completion unless the Government facility/installation is closed due to local or national emergency.

Performance shall be at Plumb Lane Armory (PLA): 685 East Plumb Lane, Reno, NV 89502; and Las Vegas Readiness Center (LVRC) and 4500 West Silverado Ranch Boulevard, Las Vegas, NV 89139. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential.

1.4.4.1 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented.

Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.4.2 The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times, and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance. The Government reserves the right to direct the removal of an employee for misconduct, security reasons, any overt evidence of communicable disease, who endanger persons or property; those who manufacture, distribute, dispense, possess or use controlled substances at the worksite; and those whose continued employment under this contract is inconsistent with the interest of military security. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

1.4.5 Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DoD), Headquarters Department of Army (HQDA) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.5.1 For contractors requiring Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential. CAC issuance requirements are as follows:

In accordance with Department of Defense Manual (DoDM) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. The issuance of a CAC will be based on four criteria: (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 3, 2017, and (d) verification of a claimed identity. Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID System (RAPIDS) using the DD Form 1172-2, or the Trusted Associate Sponsorship System (TASS).

1.4.5.1.1 HSPD-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them, and shall process all CAC card applications. The contractor shall ensure that all employees requiring an initial background investigation complete a Personnel Security Investigation Portal (PSIP) form at Attachment (to be provided after contract is awarded) at the earliest possible date and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward it to the National Guard Bureau (NGB) Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm that the investigative service provider has received the request, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e- QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the background investigation (BI) will be initiated. The contractor shall ensure immediate compliance with all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from two to six weeks and shall factor this lead time into its hiring/placement process.

The contractor shall make all reasonable efforts to ensure that contractor employees meet CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.

1.4.5.1.2 Trusted Associate Sponsorship System (TASS): The contractor shall process CAC applications through the TASS, the procedures for which are described below. Although there is no requirement for the contractor to designate a “Corporate Facility Security Officer" (FSO) to serve as its single point of contact for the BI, the TASS application process and other CAC and security-related matters, such designation facilitates these processes. If an FSO is not established, all contractor employees requiring a CAC will be required to process their own applications. The submission process for CAC applications is as follows:

1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA). The TASS TA for this requirement will be: TBD

2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at: https://www.dmdc.osd.mil/tass/. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.

3. The Government will inform the contractor's applicant, via email, of one of the following:

a. Approval.* Upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a RAPIDS station (RAPIDS Site Locator: http://www.dmdc.osd.mil/rsl/).

b. Rejection.* The Government, in separate correspondence, will provide reason(s) for rejection.

https://www.dmdc.osd.mil/tass/

c. Return. Additional information or correction to the application required by the contractor employee.

*The contractor shall maintain records of all approved and rejected applications.

1.4.5.1.3 At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification. Identity source documents must come from the list of acceptable documents included in Form I-9, OMB No. 1615-0047, "Employment Eligibility Verification."

Consistent with applicable law, at least one document from the Form I-9 list shall be a valid (unexpired) State or Federal Government-issued picture ID. The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS, and will then issue a CAC. Issued CACs will be valid for no longer than three years, or until the individual's contract end date (inclusive of any options), whichever is earlier.

1.4.5.1.4 The contractor shall return issued CACs to the DEERS office upon departure or dismissal of each contractor employee, and shall obtain a receipt for each card and provide it to the TA/COR.

1.4.5.1.5 The contractor shall manage requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The contractor shall provide at least 10 calendar days advance notice to the TA, unless there are extenuating circumstances approved by the COR or KO.

1.4.5.1.6 The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a government computer network. This can be done by going to: http://www.us.army.mil and registering as an "Army Guest," with the sponsor being the COR or a COR- designated individual if the COR is ineligible to Serve as an AKO Sponsor. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.

1.4.5.2 For contractors that do not require a CAC, but require access to a DoD facility or installation:

Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), and applicable installation, facility and area commander installation/facility access, and local security policies and procedures (provided by a government representative).

1.4.5.3 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to COMSEC review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DoD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DoD organizations. Therefore, the contractor is advised that any time contractor personnel place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DoD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

http://www.us.army.mil/

1.4.5.4 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the Army Enterprise Infrastructure (AEI). Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall:

1.4.5.4.1 Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.

1.4.5.4.2 Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil).

1.4.5.4.3 Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.

1.4.5.4.4 Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.

1.4.5.4.5 Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.

1.4.5.5 Protection of Personally Identifiable Information (PII)/Health Information Portability and Accountability Act (HIPAA). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised. Additionally, the HIPAA Privacy Rule creates national standards to protect individuals’ medical records and other personal health information. All contract employees shall complete HIPAA certification course on a yearly basis.

The contractor shall submit certificates of completion for each affected contractor and subcontractor employee, to the COR, or to the KO if a COR is not assigned, within 15 calendar days after completion of training. HIPAA training is available at http://www.health.mil/Training-Center/Joint-Knowledge- Online- JKO (https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf)

1.4.5.6 AT Level 1 Awareness Training (AT): All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete Level 1 AT within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee to the COR within 15 calendar days after completion of training. Level 1 AT is available at http://jko.jten.mil/courses/atl1/launch.html.

1.4.5.7 Information Assurance (IA)/Information Technology (IT) Training: All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.

https://informationassurance.us.army.mil/ http://www.health.mil/Training-Center/Joint-Knowledge-https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf http://jko.jten.mil/courses/atl1/launch.html

1.4.5.8 Information Awareness: All contractor employees with access to a government information system shall be registered in the Army Training Certification Tracking System (ATCTS) (https://atc.us.army.mil/iastar/index.php) at commencement of services, and shall successfully complete the DoD Information Assurance awareness training prior to access to the IS and then annually thereafter.

(https://ia.signal.army.mil/DoDIAA/).

1.4.5.9 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program. This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR within 15 calendar days after completion of training.

1.4.5.10 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractors shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training. Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.

1.4.5.11 Reserved

1.4.5.12 Reserved

1.4.5.13 Threat Awareness and Reporting Program (TARP). Per AR 381-12, Threat Awareness and Reporting Program (TARP), contractor employees with security clearances must receive annual TARP training by a counterintelligence (CI) agent or other trainer as specified in Chapter 2 Threat Awareness and Education, Section II, paragraph 2-4b. The contractor shall identify annual TARP training, personnel trained and date of training with the Monthly Progress Report.

1.4.6 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

1.4.6.1 Key Control. NOTE: All references to keys include key cards. The contractor shall establish and implement methods of ensuring that no keys/key cards issued by the Government are lost or misplaced or are used by unauthorized persons. No keys issued by the Government shall be duplicated. The contractor shall include procedures covering key control in the QCP. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the COR.

1.4.6.1.1 In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon direction by the KO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the Government replaces or re-keys the locks, the Government will deduct the total cost of lock replacement or re-keying from the monthly payment due the contractor. In the event a master key is lost or duplicated, the Government will replace all locks and keys for that system, and will deduct the total cost from the monthly payment due the contractor.

1.4.6.1.2 The contactor shall prohibit the use of the Government issued keys/key cards by any persons other than the contractor’s employees. The contractor shall prohibit the opening of locked areas by https://atc.us.army.mil/iastar/index.php https://ia.signal.army.mil/DoDIAA/ http://cdsetrain.dtic.mil/opsec/ contractor employees to permit entrance of persons other than contactor employees engaged in the performance of services in those areas, or personnel authorized entrance by the KO.

1.4.7 Special Qualifications: See Paragraph 5.2 for Key Personnel certification/qualification requirements.

1.4.8 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR Subpart 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will apprise the contractor of how the Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non- Government entities. Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed.

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 passes) to the COR within 14 days of an employee’s departure.

1.4.11. 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.

1.4.12 Reserved

1.4.13 Reserved

1.4.14 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.4.15 Reserved

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 Contracting Officer (KO): A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3 Contracting Officer Representative (COR): An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4 Defective Service: A service output that does not meet the standard of performance associated with the PWS.

2.1.5 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.6 Key Personnel: Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.7 Physical Security: Actions that prevent the loss or damage of Government property.

2.1.8 Quality Assurance: The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.9 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements.

2.1.11 Subcontractor: One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.2 Acronyms:

AEI Army Enterprise Infrastructure AFARS Army Federal Acquisition Regulation Supplement AR Army Regulation ARNG Army National Guard AT/OPSEC Antiterrorism/Operational Security AUP Acceptable Use Policy CFP/M/E Contractor Furnished Property, Materials, and Equipment CFR Code of Federal Regulations COMSEC Communication Security CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf DA Department of the Army DENCLASS Dental Classification Module DFARS Defense Federal Acquisition Regulation Supplement DOD Department of Defense DoDI Department of Defense Instruction FAR Federal Acquisition Regulation FMR Fully Medical Ready FPCON Force Protection Condition GFP/M/E/S Government Furnished Property/Material/Equipment/Services HIPAA Health Information Portability and Accountability Act HRR Health Readiness Record IA Information Assurance IMR Individual Medical Readiness IS Information System(s) JFHQ Joint Force Headquarters JTR Joint Travel Requirement KO Contracting Officer MEB Medical Evaluation Board MEDCHART Medical Chart MEDPROS Medical Data Protection System MHA Mental Health Assessment MODS Medical Operation Data Systems MRE Medical Readiness Event NGB National Guard Bureau NVARNG Nevada Army National Guard OCI Organizational Conflict of Interest PA Physicians Assistant PEB Physical Evaluation Board PHA Periodic Health Assessment PII Personally Identifiable Information PIPO Phase In/Phase Out

POC Point of Contact PoP Period of Performance PPE Personal Protective Equipment PPOM Personnel Policy Operational Message PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program SRP Soldier Readiness Processing TASS Trusted Associate Sponsorship System TE Technical Exhibit VA Veterans Administration

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S):

3.1 The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1.1 Property: Physical space inside a Government facility will be provided to the contractor to set up and outdoor space for any trailers.

3.2 Materials: Basic Office supplies will be provided such as pencils, pens, paper, etc. Government will provide sanitation supplies for work areas.

3.3 Equipment: Examination rooms will be provided for the Physicians to include a desk and computer.

The computers will have network/LAN access. Access to the LAN shall be provided for official Government business only. Transmission of information over the Internet shall be restricted in accordance with governing directives. Contractor use of the copier shall be limited to that work which is generated in the performance of this contract.

3.4 Services: None

3.4 Utilities: All utilities in the facilities wherein the events are hosted will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.

3.4.1 240 Volt, 60 Amp receptacle power sources are provided for mobile units when required.

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

4.2 List Mobile Units: None

4.3 List Materials: Contractor shall provide any necessary personal protective equipment (PPE) that is advised under the CDC guidelines. Contractor shall provide necessary supplies to complete dental exams and dental treatments on site.

5.0 Requirements: The contractor shall:

5.1 Event Requirements

5.1.1 Documentation:

PHA Event Documentation: The contractor shall use appropriate forms in accordance with AR 40-501 regulation for each service supplied. The forms are available in the regulations or may be made available through the Nevada Army National Guard Medical Command office. The contractor shall provide all documentation concerning medical treatment in hard copy format, as well as uploaded electronically into Medical Data Protection System (MEDPROS), Dental Classification Module (DENCLASS), MHA, Health Records Review (HRR), and Defense Occupational and Environmental Health Readiness System (DOEHRS). All electronic data entry shall be completed by the close of business on the day of the exam.

5.1.2 Event Summary Reporting: Provide a final report for all services provided to include the below information regarding all Soldiers receiving services. Submit report to the Government POC as designated for each event within three (3) business days of each event.

Date Location Total number of patients examined Verification of entry into all necessary electronic modules (MEDPROS, DENCLASS & MHA, Health Records Review (HRR), etc.) (PHA Events Only)

5.1.3 PHA Event Services:

5.1.3.1 Health Assessment: The contractor shall conduct Periodic Health Assessments (PHA) and Cardiovascular Screening Program (CVSP) guidelines in accordance with the AR 40-501.

5.1.3.2 Dental Exams: The contractor shall complete IAW AR 40-501 and AR 40-35.

5.1.3.3 Behavior Health Assessments: The contractor shall complete IAW AR 40-501.

5.2 Key Personnel:

5.2.1 PA: Performed by a licensed PA in their respective field of practice.

5.2.2 Behavior Health Assessments shall be performed by a licensed Social Worker, Psychologist, or Psychiatrist that are licensed in their respective fields and have a license to practice.

5.2.3 Registered Dental Assistant: Shall have completed a dental assistant program and shall be state license or certified.

5.2.4 Registered Dentist: Performed by a licensed Dentist in their respective field of practice.

5.3 Contractor Manpower Reporting Application (CMRA):

5.3.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the NVARNG via a secure data collection site.

5.3.2 The contractor shall completely fill in all required data fields using the following web address:

http://www.ecmra.mil/. Reporting inputs shall be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2021. Contractors may direct questions to the help desk at http://www.ecmra.mil.

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

Publication (Chapter/Page)

Date of Publication

Mandatory or

Advisory

Website

Title 29, Code of Federal Regulations, Part 1910:

Occupational Safety and

Health Standards

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

Title 29, Code of Federal Regulations, Part 1960:

Safety and Health Provisions for Federal

Employees

Current Mandatory https://www.osha.gov/dep/ffshc/standards.html

Threshold Limit Values(TLV’s) and

Biological Exposure Indices (BEI’s), American

Conference of Governmental Industrial

Hygienists (ACGIH), Cincinnati, Ohio.

Current Advisory https://www.acgih.org/tlv-bei-guidelines/tlv-chemical-substances-introduction

Army Regulation 40-5, Preventive Medicine

25 May 2007 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/r40_ 5.pdf

Department of Defense 6055.05M, Occupational

Medical Surveillance

2 May 2007 Mandatory https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/d odm/605505mp.pdf?ver=2017-08-14-111314-123

Army Regulation 11-34, The Army Respiratory

Protection Program

25 July 2013 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/r11_ 34.pdf

Department of the Army Pamphlet 40-506, The

Army Vision Conservation and Readiness Program

15 July 2009 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/p40_ 506.pdf

DoDM 5200.2 Regulation

5200.02 Procedures for the

DoD Personnel Security Program (PSP)

04/03/2017 Mandatory http://www.dtic.mil/whs/directives/corres/pub1.html http://www.ecmra.mil/ http://www.ecmra.mil/ http://www.dtic.mil/whs/directives/corres/pub1.html

Army Directive 2014-05 Policy and Implementation

Procedures for Common Access Card Credentialing and Installation Access for

Uncleared Contractors

03/07/2014 Mandatory http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.asp x

AR 190-13

The Army Physical Security

Program

02/25/2011 Mandatory http://www.apd.army.mil/ProductMaps/PubForm/AR.aspx

Homeland Security Presidential Directive

(HSPD)-12

Policy for a Common

Identification Standard for Federal Employees and

Contractors

08/27/2004 Mandatory https://www.dhs.gov/homeland-security-presidential-directive-

DoDD 5400.11 Department of Defense

Privacy Program

10/29/2014 Mandatory http://www.dtic.mil/whs/directives/corres/dir.html#

DoD 5400.11-R Department of Defense

Privacy Program

05/14/2007 Mandatory http://www.dtic.mil/whs/directives/corres/pub1.html

DoDD 8140.01 Cyberspace Workforce

Management

08/11/2015 Mandatory http://www.dtic.mil/whs/directives/corres/dir.html

DoD 8570.01-M Information Assurance

Workforce Improvement Program

12/19/2005 (Change 4:

11/10/2015)

Mandatory http://www.dtic.mil/whs/directives/corres/pub1.html

AR 25-2

Information Assurance

10/24/2007 Mandatory http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 530-1

Operations Security

09/26/2014 Mandatory http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 40-501, Standards of Medical Fitness

Current Mandatory http://www.apd.army.mil

AR 40-35 Dental Readiness And Community Oral

Health Protection

Current Mandatory http://www.apd.army.mil

CDC Guidelines Current Mandatory https://www.cdc.gov/coronavirus/2019-ncov/index.html

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

Form Date Website

DD 1172-2

Application for Identification

Card/DEERS Enrollment

Mar 2017 http://www.dtic.mil/whs/directives/forms/index.htm

I-9 Employment Eligibility Verification

11/14/16 https://www.uscis.gov/sites/default/files/files/form/i-9.pdf http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx http://www.apd.army.mil/ProductMaps/PubForm/AR.aspx https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.dhs.gov/homeland-security-presidential-directive-12 http://www.dtic.mil/whs/directives/corres/dir.html http://www.dtic.mil/whs/directives/corres/pub1.html http://www.dtic.mil/whs/directives/corres/dir.html http://www.dtic.mil/whs/directives/corres/pub1.html http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://www.apd.army.mil/ http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/index.htm https://www.uscis.gov/sites/default/files/files/form/i-9.pdf

DD 441

Department of Defense Security

Agreement

Jan 2017 http://www.dtic.mil/whs/directives/forms/dd/ddforms0001- 0499.htm http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm

TECHNICAL EXHIBIT 1

Performance Requirements Summary

This PRS includes performance objectives the Government will use to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

Performance Objective

Performance Standard Acceptable Quality Levels

(AQL)

Surveillance Method / By Whom

5.1.1 Provide

Surveillance Test and Exam

The contractor shall provide two hard copies of all medical surveillance tests and exams to the Government POC designated within five (5) calendar days of each event.

No more than five (5) tests or exams provided later than five (5) calendar days after event during the PoP.

100% Inspection /

COR

5.1.2 Event Summary

Reporting

Provide a final report for all services provided regarding all soldiers receiving services.

Submit report to the Government POC as designated for each event within three (3) business days of each event.

No more than two (2) summary reports received later than three (3) business days after event during the PoP

100% Inspection /

COR

5.1.3 PHA Services

PHA assessments, testing, screening and services are provided IAW applicable regulations

No more than two (2) instances per event of services not IAW applicable regulations

100% Inspection /

COR

5.1.3.2 Dental

Exams

Perform dental examinations, digital bitewings and digital panoramic radiographs IAW AR 40-501 and AR 40-35.

No more than one (1) exam per event no IAW ARs. Treatment will be consistent with identified treatment plan and only one (1) session per event per Service Member

100% Inspection /

COR

5.1.3.3 Behavior

Health Services

Mental Health Assessments associated with the DoD PHA

IAW AR 40-501.

No more than two (2) instances per event of services not IAW applicable regulations

100% Inspection /

COR

TECHNICAL EXHIBIT 2

Surveillance Deliverables Schedule

PWS Reference / Deliverable Title Frequency Number of

Copies Medium/Format Submit To

1.4.5.5 Initial and annual HIPAA training

certificates

Provide within one (1) calendar day after employee completes training.

1 Electronic Submission

COR

1.4.5.6 AT Level 1

Awareness Training Certificates

Provide within one (1) calendar day after employee completes training.

1 Electronic Submission

COR

1.4.5.7 IA/IT Training

Certificates

Provide within one (1) calendar day after employee completes training.

1 Electronic Submission

COR

1.4.5.9 iWATCH Training

Certificates

Provide within one (1) calendar day after employee completes training.

1 Electronic Submission

COR

1.4.5.10 OPSEC Training

Certificates

Provide within one (1) calendar day after employee completes training.

1 Electronic Submission

COR

1.4.10 Contractor Badges

Provide within one (1) day of an employee’s departure.

1 Physical Delivery

COR

5.1.1 Examination

Documentation

Provide by close of business the day of the exam (electronically) and within three (3) business days of each event (hard copy);

2 Electronic Submission Physical Delivery

COR

5.1.2 Event Summary

Report

Provide within three

(3) business days of each event

1 Electronic Submission

FAR Clause 52.237-7 Medical Liability

Insurance

Prior to the start of contract performance

1 Electronic Submission

TECHNICAL EXHIBIT 3

(This information is provided for forecasting only. It is not a guarantee of workload quantities.)

Medical Readiness Exams Estimated Workload Data

ITEM EVENT ESTIMATED QUANTITY

1 April Plumb Lane Armory 135 Soldiers 2 April Las Vegas Readiness Center 250 Soldiers 3 May Las Vegas Readiness Center 250 Soldiers