Attachment_1_-_Performance_Work_Statement_20_May_2019.pdf

PERFORMANCE WORK STATEMENT (PWS)

For Occupational Health Care (OHC) and Consultation

Services for USFORAZORES Civilian Employees at Lajes Field

20 May 2019

Table of Contents

1.0. Description of Services

1.1. Technical Definitions Peculiar to this PWS

1.2. Occupational Health Care

1.3. Personnel

1.4. Communication

1.5. Security Requirements

1.6. Hours of Operation

1.7. Inclement Weather Conditions

1.8. Government Observations

1.9. Standard Definitions

1.10. Contractor Furnished Items and Services

1.11. Quality Control

1.12. Invoicing…

2.0. Services Summary (SS)

3.0. Government-Furnished Services

4.0. Enterprise-Wide Contractor Manpower Reporting Application Reporting

5.0. Abbreviations and Translation Terms in PWS

5.1. List of Applicable Publications (current editions)

6.0. Attachment I : Exam List

1.0. Description of Services.

This is a non-personal services Performance Work Statement (PWS) for Occupational Health Care (OHC) and consultation services for civilians employed by United States Forces Azores (USFORAZORES) at Lajes Field. The contractor shall provide all personnel, equipment, tools, materials, supervision and other items and services necessary to perform OHC and occupational safety and health advisory/consultation. The contractor will receive phone calls and emails from the Contracting Officer Representative (COR) periodically throughout the contract to make appointments and provide the tests in the exam list. The exam list with the different quantities and base and option years is Attachment I of this document.

1.1. Technical Definitions Peculiar to this PWS.

1.1.1. The Government. Refers to the United States Government, as used herein, it refers specifically to the USFORAZORES, the 86 Airlift Wing and the 65th Air Base Group.

1.1.2. Contracting Officer (CO). The only person authorized to obligate funds on behalf of the Government. Any changes to this PWS and contract requirements must be coordinated and approved through the CO, prior to any changes in work being performed.

1.1.3. Contracting Officer’s Representative (COR). The person designated for the administration of the contract. Maintains liaison with own staff, the contractor, and customers related to the project.

1.1.4. Medical Occupational Health Administrator (MOHA). Military or Civilian Patient Liaison/technician and/or officer assigned to the occupational health section of the Medical Aid Station (MAS) will be authorized to place calls on behalf of the Government.

1.2. Occupational Health Care. The Occupational Health Provider (OHP) shall provide OHC to designated employees IAW U.S. legal norms (See para 5.1.). The OHP must be available Monday through Friday during the work hours 0800-1600. The OHP shall perform medical examinations requirements per United States Air Force (USAF) regulations, including but limited to Air Force Instruction (AFI) 48-145, Occupational and Environmental Health Program, and Air Force Manual (AFMAN) 48-146, Occupational and Environmental Health Program Management. The contractor must schedule the initial requested medical appointment within five (5) work days and provide a completion certificate of all medical services provided within five (5) work days of examination or consultation, as appropriate.

1.3. Personnel.

1.3.1. Contract Manager (CM). The contractor shall identify a primary CM responsible for reporting services and an alternate representative in the event of absences by the primary. Names and telephone numbers shall be submitted in writing to the CO and each MOHA within 5 work days after contract award.

1.3.2. Primary Physicians. They are established by the CM who will provide the required service and will be the appointed OHP.

1.3.3. Employees.

1.3.3.1. Contractor’s Personnel. The selection, assignment, reassignment, transfer, supervision, management, and control of contractor employees shall be the sole responsibility and prerogative of the contractor; however, the contractor shall comply with the general intent and specific policies set forth in this PWS. When the CO directs, the contractor shall restrict the employment under the contract or remove from performance on the contract any person who is identified as a potential threat to the health, safety, security, general well-being or operational mission of the Government.

1.3.3.2. Certifications and Licenses. The OHP shall ensure that employees have current and valid professional certifications/licenses and health certificates when performing services. The OHP must be licensed to practice medicine in the Republic of Portugal. They must also be trained in the specialty of occupational medicine or under the direct supervision of a physician trained in the specialty. The OHP ensures availability of certificates/licenses for Government review upon request. Any change of personnel or any change to their status must be submitted to the CO, COR and MOHA within three (3) work days.

1.4. Communication.

The OHP shall provide at least one individual at each examining facility who is able to read, write, speak and understand Portuguese and English at a level necessary to fully perform all required duties and tasks described in the PWS. The contractor must schedule the initial requested medical appointment within ten (10) work days of request and provide a completion certificate listing all services provided in English.

1.5. Security Requirements.

1.5.1. Confidentiality. The OHP and secondary staff shall maintain confidentiality concerning all USAF internal matters revealed to them during their surveillance or consultation with the agency, especially agency’s business secrets. This also applies to all documentation in the possession of the OHP.

1.5.2. Automated Data Processing System. The OHP shall store, process, protect, and maintain all necessary medical records for civilians employed by the US government to fulfill the requirements of this PWS and provide copies to the COR when requested IAW US Privacy Act of 1974, and its applicable Amendments.

1.5.3. Assessment Data. The contractor has the sole responsibility for the accuracy of assessment data inputs and outputs as well as for a safe maintenance of this data in its record keeping system.

Any assessment data shall not be released except as specified in this PWS or as specifically required by USAF regulations. The contractor shall also cooperate with 86 MDG (Medical Group) Occupational Health staff, responsible for implementing the accident prevention and occupational safety and health program, administered at Lajes Field by the 65 Air Base Group, Medical Aid Station.

1.5.4. Disposition of Employee Records. The OHP shall maintain and dispose all civilian employee’s medical records IAW US Privacy Act of 1974, and its applicable amendments.

1.5.5. Cooperation in Transition. If a transition of performance will become necessary upon contract expiration, the OHP shall cooperate with a subsequent OHP to assure uninterrupted services and inform the subsequent OHP of all pending requirements for examinations. Medical records shall be forwarded to a subsequent OHP upon request by the COR.

1.5.6. Monthly Reporting Requirement. The OHP shall prepare a list of all civilian employees examined and receiving OHC. This list shall contain names, identification numbers, and date and type of service performed. This report shall be provided to the MOHA on a monthly basis by the 10th calendar day of the following month.

1.6. Hours of Operation.

1.6.1. Normal Hours. The contractor shall provide the required services Monday through Friday, during the work hours 0800-1600 excluding Portuguese holidays. The Following Portuguese holidays will be observed:

New Year’s Day 1 January Mardi Gras varies yearly Good Friday varies yearly Day of Liberty 25 April Day of the Worker 1 May Espirito Santo Monday varies yearly Day of Portugal 10 June Corpus Christi varies yearly Praia da Vitoria Day varies yearly Assumption Day 15 August Founding of the Republic 5 October All Saints’ Day 1 November Restoration of Independence Day 1 December Immaculate Conception 8 December Christmas Day 25 December

1.7. Inclement Weather Conditions. On occasion, due to inclement weather conditions, the base may be closed. The Government will not be financially liable for any missed scheduled appointments by civilian employees. For this or any other reason payment will be made only for services rendered or examinations performed.

1.8. Government Observations. Government personnel, to include but not limited to COs, CORs and other appropriate personnel, may periodically observe but not interfere with contractor operations.

1.9. Standard Definitions.

1.9.1. Quality Assurance. Those actions taken by the United States Government to assure services meet the requirements of the PWS.

1.9.2. Quality Control. Those actions taken by a contractor to control the performance of services so that they meet the requirements of this PWS.

1.10. Contractor Furnished Items and Services.

1.10.1. General. Except for those services specifically stated to be Government furnished in paragraph 3.0, the contractor shall furnish all items and services required to perform the work.

1.10.2. Examination Facilities. All OHC and examinations shall be conducted at the OHP facilities, and ensure that the facilities contain the appropriate equipment for required examinations.

1.11. Quality Control.

The Quality Control Plan (QCP) shall be a comprehensive plan detailing how the OHP intends to ensure the delivery of quality services to the Government and how quality levels will be maintained. The QCP shall cover all services described in this PWS. The OHP is required to notify the COR immediately when there is a problem caused by the Government. The QCP shall include, but is not limited to the following general features:

1.11.1. Methods of communication with the Government regarding performance of this PWS. The communication shall include correspondence, formal meetings with the Government as well as written documentation.

1.11.2. Medical Records Keeping. The QCP shall address how all documentation will be created/maintained. Copies of written reports shall be picked up by MAS personnel staff.

1.11.3. Surveillance Methods. Specific surveillance techniques of all services required in this PWS shall be described. The surveillance methods shall be comprehensive and adaptable to the reporting system of the QCP.

1.11.4. Corrective Actions. The QCP shall identify potential problem areas and address corrective actions for any deficiencies that may occur in performance of this contract, including short-term remedial actions and long-term solutions. The contractor shall address what actions will be taken to ensure responses are prompt to correct deficiencies discovered in contract performance without Government guidance. Internal records shall be kept of these situations as well as corrective action implemented.

1.12. Invoicing.

The contractor will submit the invoice from the previous month in the first week of the following month. For example, all exams provided during the month of June will be submitted to the COR in the first week of July via email and Wide Area Workflow (WAWF) under 252.232-7006 Wide Area Workflow Payment Instructions (May 2013). The contractor will only invoice for the exams provided for that month.

2.0. Services Summary (SS)

Performance Objective PWS Para Performance Threshold

Method of Assessment

SS-1

OHP services and completion certificates are provided within the specified timeframes.

1.2 95% of the time 100% Inspection tracked by MOHA

SS-2

Availability of physician for Consultations/Work center visits

1.2. 95% of the time 100% Inspection tracked by MOHA

SS-3

Receipt of monthly visit report within required

1.5.6 95% of the time 100% Inspection tracked by MOHA

3.0. Government-Furnished Services/Information

3.1. The MOHA will supply the OHP with the employee health data sheet to request OHC or exams according to workplace exposure.

3.2. The Government will make available to the OHP to visit civilian employee worksites.

4.0. Enterprise-Wide Contractor Manpower Reporting Application Reporting.

The contractor shall ensure ALL contractor labor hours including subcontractor, at all levels/tiers, labor hours required for the performance of services provided under this contract are reported via a secure data collection site.

The contractor and all subcontractors, at all levels/tiers, providing direct labor under this contract shall report complete and accurate data for the labor executed during the period of performance during each Government fiscal year (FY), which runs from October 1 to September 30. The Contractor shall input the data into the appropriate eCMRA reporting tool, which can be accessed via a secure web site at http://www.ecmra.mil/. There are four separate eCMRA tools:

Army, Air Force, Navy and All Other Defense Components. The appropriate eCMRA reporting tool to use is determined by the requiring activity being supported (e.g., if DISA awards a contract for an Air Force requiring activity, the contractor shall load the required reporting data in the “Department of Air Force CMRA” tool). While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. The contractor shall completely fill in all required data fields. The contractor shall enter initial data into the appropriate eCMRA tool to establish the basic contract record no later than 15 working days after receipt of contract award or contract modification incorporating this clause. The contractor shall notify the COR when the basic contract record has been established in the appropriate eCMRA tool.

eCMRA User Manuals and Frequently Asked Questions (FAQs) are available at http://www.ecmra.mil/

Contractors may direct technical questions to the eCMRA help desk at usaf.pentagon.safaq.

mbx.cmra-help-desk-dod@mail.mil

5.0. Abbreviations and Translation Terms in PWS

CM Contract Manager CO Contracting Officer COR Contracting Officer Representative OHP Occupational Health Provider IAW in accordance with LN Local National MAS Medical Aid Station MDG Medical Group MOHA Medical Occupational Health Administrator OHC Occupational Health Care PWS Performance Work Statement QCP Quality Control Plan SS Services Summary USAF United States Air Force USAFE United States Air Force in Europe USFORAZORES United States Forces Azores

5.1. List of Applicable Publications (current editions)

AFI 48-145* Occupational Health Program (http://www.e-publishing.af.mil/)

Air Force Manual (AFMAN) 48-146* Occupational and Environmental Health Program Management

AFOSH Standards* (http://www.e-publishing.af.mil/)

29 CFR 1910* OSHA Safety and Health Standards (https://www.osha.gov/pls/oshaweb/owastand.display_standard_group?p_t oclevel=1&ppartnumber=1910)

DODM 6055.5* Occupational Health Surveillance Manual http://www.dod.mil/pubs/

Threshold Limit Values for Chemical Substances and Physical Agents/Biological Exposure Indices for (current year). American Conference of Governmental Industrial Hygienists. ** (http://www.acgih.org/home.htm).

6.0. ATTACHMENT I

EXAM LIST

OCCUPATIONAL HEALTH PHYSICIAN

BASE YEAR

CLIN

EXAM TYPE

QUANTITY

UNIT

UNIT PRICE

AMOUNT

Physical Examination (To include in‐ person/face to face exam, documented review of results from any applicable exams performed under CLINs 0003‐0016, plus exam and documentation of Height, Weight, Blood Pressure, and medical history)

63 Each

Medical Examination (Non in‐person, non‐ face‐to‐face documented review of results from any applicable exams performed under CLINs 0003‐0016)

216 Each

0003 Audiogram 279 Each

0004 BUN and Creatinine 63 Each

0005 CBC with Diff 28 Each

0006 Confrontational Fields 63 Each

0007 Electrocardiogram 28 Each

0008 Fecal Occult Blood 28 Each

0009 Lipid Panel 28 Each

0010 Liver Function Panel 28 Each

0011 Prostate Exam 4 Each

0012 Spirometry 63 Each

0013 Urine Glucose 28 Each

0014 Urine Microalbumin 28 Each 0015 Visual acuity 63 Each

Total:

EXAM LIST

OPTION YEAR 1

Physical Examination (To include in‐ person/face to face exam, documented review of results from any applicable exams performed under CLINs 0003‐0016, plus exam and documentation of Height, Weight, Blood Pressure, and medical face‐to‐face documented review of results from any applicable exams performed

1003 Audiogram 279 Each

1004 BUN and Creatinine 63 Each

1005 CBC with Diff 34 Each

1006 Confrontational Fields 63 Each

1007 Electrocardiogram 34 Each

1008 Fecal Occult Blood 34 Each

1009 Lipid Panel 34 Each

1010 Liver Function Panel 34 Each

1011 Prostate Exam 5 Each

1012 Spirometry 63 Each

1013 Urine Glucose 34 Each

1014 Urine Microalbumin 34 Each 1015 Visual acuity 34 Each

OPTION YEAR 2

Physical Examination (To include in‐ person/face to face exam, documented review of results from any applicable exams performed under CLINs 0003‐0016, plus exam and documentation of Height, Weight, Blood Pressure, and medical face‐to‐face documented review of results from any applicable exams performed

2003 Audiogram 279 Each

2004 BUN and Creatinine 63 Each

2005 CBC with Diff 40 Each

2006 Confrontational Fields 63 Each

2007 Electrocardiogram 40 Each

2008 Fecal Occult Blood 40 Each

2009 Lipid Panel 40 Each

2010 Liver Function Panel 40 Each

2011 Prostate Exam 5 Each

2012 Spirometry 63 Each

2013 Urine Glucose 40 Each

2014 Urine Microalbumin 40 Each 2015 Visual acuity 63 Each

OPTION YEAR 3

Physical Examination (To include in‐ person/face to face exam, documented review of results from any applicable exams performed under CLINs 0003‐0016, plus exam and documentation of Height, Weight, Blood Pressure, and medical face‐to‐face documented review of results from any applicable exams performed

3003 Audiogram 279 Each

3004 BUN and Creatinine 63 Each

3005 CBC with Diff 44 Each

3006 Confrontational Fields 63 Each

3007 Electrocardiogram 44 Each

3008 Fecal Occult Blood 44 Each

3009 Lipid Panel 44 Each

3010 Liver Function Panel 44 Each

3011 Prostate Exam 5 Each

3012 Spirometry 63 Each

3013 Urine Glucose 44 Each

3014 Urine Microalbumin 44 Each 3015 Visual acuity 63 Each

OPTION YEAR 4

Physical Examination (To include in‐ person/face to face exam, documented review of results from any applicable exams performed under CLINs 0003‐0016, plus exam and documentation of Height, Weight, Blood Pressure, and medical face‐to‐face documented review of results from any applicable exams performed

4003 Audiogram 279 Each

4004 BUN and Creatinine 63 Each

4005 CBC with Diff 63 Each

4006 Chest X‐Ray 63 Each

4007 Confrontational Fields 63 Each

4008 Electrocardiogram 63 Each

4009 Fecal Occult Blood 63 Each

4010 Lipid Panel 28 Each

4011 Liver Function Panel 63 Each

4012 Prostate Exam 7 Each

4013 Spirometry 63 Each

4014 Urine Glucose 63 Each

4015 Urine Microalbumin 63 Each 4016 Visual acuity 63 Each