Attachment_1-PWS_19_Jun_13_Dental_Assitant_Testing_and_Certifcation.docx

AIR FORCE MEDICAL OPERATIONS AGENCY (AFMOA)

PERFORMANCE WORK STATEMENT (PWS)

FOR

DENTAL ASSISTING NATIONAL BOARD CERTIFICATION TESTS

19 June 2013

TABLE OF CONTENTS

Page

3.0 Quality Control Plan 6

4.0 Non Personal Service 7

5.0 Hours of Operation 7

6.0 APPENDICES: 7

6.1 Appendix A HQ AF/SG Organizational Conflict of Interest 8

6.2 Appendix B HQ AF/SG Non-Disclosure Agreement 11

6.3 Appendix C Customer Complaint Record 13

1.0 DESCRIPTION OF SERVICES

1.1 BACKGROUND. The mission of the Air Force Medical Operations Agency (AFMOA) South is to support Department of Defense (DoD) health professionals in optimizing the health and wellness of their populations through appropriate, effective and efficient healthcare practices and service delivery. The United States Air Force (USAF) is committed to taking care of its own. Our Air Force (AF) members and their families deserve the best support possible. AF readiness targets all areas of medical and dental care. A key element of medical/dental readiness is training, and current career knowledge with a steady cross flow of knowledge and interaction with the civilian healthcare community.

1.2 SCOPE. The AF Dental Service executive board strives to ensure dental assistants receive timely, current training and nationally recognized certification for the knowledge and skills gained during training. Dental Assisting National Board (DANB) certification testing is the gold standard proficiency measurement, and DANB is currently the only agency recognized by the American Dental Association to award certificates of competency.

1.3 ACRONYMS

2.0 SUMMARY OF REQUIREMENTS: The contractor shall support AFMOA and the AF Dental Service by providing certification testing services relating to Dental Assistant National Board (DANB) certification. This shall be accomplished by providing the DANB Infection Control (IC) and Radiation Health and Safety (RHS) examinations to students in the Dental Assistant Apprentice course. Upon successful completion of the exams DANB will issue certificates of competency.

2. 1 SERVICES SUMMARY. The COR is responsible for review and approval of all deliverables and contract performance, and will periodically evaluate the contractor’s performance to ensure services are received. The COR may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints submitted to the COR and forwarded to the contractor on the Customer Complaint form, see appendix 6.3. Likewise, the COR may decrease the number of quality control inspections if performance dictates. The COR shall make final determination of the validity of customer complaints.

2.1.1 Measurable Terms

Provide 225 Infection Control examinations. Provide access to IC practice test for 6 months, for each individual test taker.

2.0, 2.4.1, 2.4.1.1, & 2.4.1.2 100% Completion

Periodic Inspection

Periodic Inspection

Customer Feedback

2.2 GOVERNMENT FURNISHED PROPERTY: N/A

2.3 TRAVEL: None Required

2.4 DELIVERABLES: All documents and contract data deliverables described in this PWS shall be submitted by the contractor and meet the requirements set forth in the following paragraphs 2.4.1 thru 2.4.5.5.

2.4.1 PROVIDE 225 INFECTION CONTROL EXAMINATIONS

2.4.1.1 The contractor will make available a total of 225 DANB IC examinations per performance period.

2.4.1.2 Provide access to IC practice test for six (6) months for each individual test taker.

2.4.2 PROVIDE RADIATION HEALTH AND SAFETY EXAMINATIONS

2.4.2.1 The contractor will make available a total of 225 DANB RHS examinations per performance period.

2.4.2.2 Provide access to RHS practice test for six (6) months for each individual test taker.

2.4.3 QUARTERLY STATUS/FINANCIAL REPORT.

2.4.3.1 The contractor shall prepare and submit a quarterly status/financial report identifying all tasks performed, status, issues, and anticipated actions consistent with the PWS.

2.4.3.2 One electronic copy of this report shall be submitted to the Contracting Officer (CO) and one to the Contracting Officer Representative (COR), by the tenth working day of the month following the end of the reporting period. Electronic copies will also be forwarded to the Air Force Career Field Manager for Dental Services.

2.4.3.3 Specific content of the report shall be coordinated with the COR and delivered in an electronic format mutually agreed by the contractor and the Government.

2.4.3.4 The report shall include the following items:

2.4.3.4.1 The number of tests provided within quarter.

2.4.3.4.2 Summary of test results for the quarter and aggregate totals for the performance period.

2.4.3.4.3 Status of COR generated action items, if any, from previous report and the resultant impact and schedule changes, if any.

2.4.3.5 This report shall also keep the Government informed of all funds expended to-date and a forecast of future costs for each effort.

2.4.4 CERTIFICATES OF COMPETENCY

2.4.4.1 The contractor will provide to each person that successfully completes the IC and/or RHS examinations with an official score report and a DANB certificate of competency. If a person fails an examination the contractor will only be required to provide the official score report.

2.4.4.2 The contractor shall maintain student test and certification records for 5 years.

2.4.5 CUSTOMER SUPPORT

2.4.5.1 Contractor shall have the site available 24/7/365.

2.4.5.2 Contractor shall provide 24 hour helpdesk support (Email) to assist members experiencing problems with on-line student examination score data. Email and helpdesk support requested on weekends and after normal DANB working hours will be responded to by the next DANB work day.

2.4.5.3 Contractor shall provide at least two admin IDs for access to the tests (One ID for the Primary COR and one for the Alternate COR) and report information such as historical information.

2.4.5.4 Contractor will not have the system down for routine maintenance or unforeseen problems more than a total of 48 hours in any 3 months period (Oct-Dec, Jan-Mar, Apr-Jun, and Jul-Sep) Contract will provide notification to the primary and alternate COR at least 5 working days in advance of any down time of the test site.

2.4.5.5 Contractor shall provide a direct point of contact (POC) for working contract related matters.

3.0 QUALITY CONTROL PLAN. The Contractor is responsible for Contract Management and Quality Control, not the Government.

3.1 The Contractor shall be responsible for quality control (QC) for all work accomplished during the performance of this contract. All work shall be accomplished using the best commercial practices and be within the Government guidelines. Work and documentation produced by the contract personnel will be regularly reviewed by the COR.

3.2 Quality Control Plan (QCP). The contractor shall provide to the government a QCP at time of proposal and any updates after contract award. Any update to the QCP must be reviewed by the COR and Contracting Officer.

4.0 NON PERSONAL SERVICES. The Government will neither supervise contractor employees nor control the method by which the contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor employ.

It shall be the responsibility of the contractor to manage its employees and to guard against any actions that are of the nature of personal services, or give the perception of personal services. If the contractor feels that any actions constitute, or are perceived to constitute personal services, it shall be the contractor's responsibility to notify the CO immediately. These services shall not be used to perform work of a policy/decision making or management nature, i.e., inherently Governmental functions. All decisions relative to programs supported by the contractor shall be the sole responsibility of the Government.

4.1 Contractor personnel shall not release any personnel person-level content with personal information, during the course of this contract. Information shall be treated IAW the following: The Privacy Act of 1974 (5 U.S.C. 552a), which includes Public Law 100-503, Department of Defense Directive (DoDD) 5400.11, and DoD 5400.11-R and must be treated as FOR OFFICIAL USE ONLY. And the Contractor shall provide to the COR within ten (10) days after contract award, a signed Organizational Conflict of Interest OCI, see appendix 6.1, Avoidance or Mitigation Plan, addressing the activity of all contract employees and non-disclosure statements, see appendix 6.2.

5.0 HOURS OF OPERATION

5.1 Customer Service and Help Desk. The contractor will provide 24/7/365 Customer Service and Help Desk support to site administrators and students to resolve technical problems. These services will be accessible through a contractor provided toll-free number, web, and e-mail.

6.0 APPENDICES

6.1 APPENDIX A. HQ USAF/SGR Organizational Conflict of Interest

6.2 APPENDIX B HQ AF/SG Non-Disclosure Agreement

6.3 APPENDIX C. Customer Complaint Form

APPENDIX A: HQ AF/SG ORGANIZATIONAL CONFLICT OF INTEREST

Revised: 30 Aug 2007

The purpose of this clause is to accomplish the following three objectives: (1) to inform prospective Offerors that Air Force Surgeon General (AF/SG) presumes that award of this contract or task order may give rise to real or apparent Organizational Conflict of Interest (OCI) with respect to other requirements or contracts within the Air Force Medical Service (AFMS); (2) to assist current contractors and prospective Offerors in developing their own business strategies regarding participation in AFMS requirements and in identifying and, where possible, avoiding or mitigating against OCIs; and (3) to ensure that all current contractors and prospective Offerors are afforded the maximum practicable opportunity to compete for all AFMS requirements consistent with the restrictions required under FAR Subpart 9.5, Government Accountability Office or Court of Federal Claims decisions, and sound business practices.

The contractor and all of its agents (including officers, managers, employees, consultants, and subcontractors) will fully comply with the Special Terms and Conditions OCI required for efforts in support of Air Force Medical Support Agency (AFMSA) activities. Contractor will ensure that all confidential and sensitive information will be fully protected. Such information will include, but not be limited to; all source selection sensitive information, government plans or strategies, and all proprietary information of other companies during contract performance. The disclosure of information shall not constitute a grant of any species of right, title, interest, or property in or to said information.

The contractor understands and appreciates the absolute need to prevent conflicting roles that could or may bias its support to the AFMS office and its AF-wide responsibilities. To ensure that any support provided by the contractor, its personnel, or its agents, is free of any bias in judgment or objectivity and to preclude the contractor, its personnel, or its agents, from any unfair competitive advantage in current or future acquisitions, the contractor will implement the following:

1. Organizational Isolation

1. Company Wide Policy Implementation

1. Non-Disclosure Agreements

Contractor participation in a requirement or contract with AFMS programs may give rise to an unfair competitive advantage in other AFMS procurement actions because of access to advance acquisition planning, source selection sensitive or proprietary information. Furthermore, contractor participation in one area may give rise to a real or apparent loss of contractor impartiality and objectivity where its advisory or planning assistance in one area potentially affects its present or future participation in another area.

For purposes of identifying, avoiding and/or mitigating against OCIs, AFMS will examine all its requirements and acquisitions for potential OCI or ethical problems, regardless of the cognizant contracting activity (e.g., AFMC, VA, GSA, other agency Multiple Award Schedules, etc.) or the type of contract vehicle used (e.g., FSS order, Multiple Award IDIQ Contracts, BPAs, FAR Part 15 competitively awards, etc.).

An Offeror/contractor wishing to submit an offer for this procurement, or any Offeror/contractor which provides or previously has provided support to AFMS, must include the following as part of its offer:

1. Perform a comparative analysis of the potential new work against all current and previous work performed in support of AFMS. The comparative analysis must be included in the proposal for the new work, and must include a statement certifying whether the contractor believes that its performance of the proposed new work would create a real or apparent OCI. If the contractor believes that no real or perceived OCI will result from an award of the proposed work, no additional action by the contractor is required.

1. If the Offeror/contractor believes that a real or apparent OCI may exist as a result of an award, the contractor shall also submit an OCI Avoidance or Mitigation Plan with its proposal.

Inclusion of the comparative analysis and OCI Avoidance or Mitigation Plan will not be counted against any offer page limitations otherwise stated in the solicitation.

The Contracting Officer (and when applicable the appropriate program office, acquisition manager, and legal counsel) will review the comparative analysis and, if provided, the Avoidance or Mitigation Plan, in accordance with the requirements of FAR Subpart 9.5 (Organizational Conflict of Interest) to make an independent determination of whether award to that Offeror would be consistent with those requirements. If it is unilaterally determined by the Contracting Officer that no OCI would arise or that the OCI Avoidance or Mitigation Plan adequately protects the interests of the government in the event of award to that Offeror, the Offeror will be determined, for purposes of this clause, to be eligible for award.

If the Offeror/contractor knows of no OCI in accepting work under this contract, it shall certify its OCI status and submit the certification at the end of this clause with its proposal and any later award, if awarded the contract. The contractor shall also obtain a similar certification of OCI status from all subcontractors, teaming partners or consultants prior to tasking any such party under this contract. The contractor shall appropriately modify and include this clause, including this paragraph, in all consulting agreements and subcontracts of any tier to preserve the rights of the Government.

For breach of any of the above restrictions or for nondisclosure or misrepresentation of any relevant facts required to be disclosed concerning this contract, the Government may terminate this contract, disqualify the contractor from subsequent related contractual efforts, and pursue any remedies as may be permitted by law or this contract.

Prior to a contract modification involving a change to the Performance Work Statement, or an increase in the level of effort or extension of the term of the contract, the contractor shall submit any applicable organizational conflict of interest disclosure or an update of the previously submitted disclosure or representation.

The Offeror/contractor should review the considerations below in determining whether or not a conflict of interest exists.

1. Does the Offeror or any intended subcontractors, teaming partners, proposed employees, or affiliates have Unequal Access to Information? Would award to the Offeror result in the Offeror having the opportunity to access nonpublic information that may give the Offeror a competitive advantage in a later competition for a government contract? Specifically, will the Offeror/contractor have access to any of the following information:

0. Budget(s) or Budget Information?

0. Acquisition Sensitive Information related to the procurement process to include, but not limited to Acquisition Plans, Requirements, Statements of Work, or Evaluation Criteria?

1. Does the Offeror or any intended subcontractors, teaming partners, proposed employees, or affiliates have “impaired objectivity” because the Offeror’s ability to render impartial judgments may be compromised because of its conflicting role(s) on this effort and other government contracts?

1. Do “biased ground rules” exist? Most commonly, this would include a situation where the Offeror has, as a government contractor, written specifications or a statement of work for this effort, which could skew competition in favor of itself?

1. Is the Offeror aware of any other information relating to this proposed contract/order, which could reasonably be construed as creating an OCI?

The Offeror/contractor hereby certifies to the best of its knowledge its OCI status below:

(Offeror: Choose one of the following two statements. Delete the statement that does not apply.)

No real or perceived OCI, as defined in FAR 2.1 and discussed in FAR 9.5, will result from an award of the proposed work (there are no ‘Yes’ responses to the questions above).

A real or apparent OCI may exist as a result of an award and therefore an appropriate OCI Avoidance or Mitigation Plan is attached (Offeror shall include an appropriate OCI Avoidance or Mitigation Plan, as required by this clause, with its proposal to the Contracting Officer. [NOTE: Either delete statement #2, or delete the last phrase allowing them to submit it, or include following statement re Mitigation Plan f related to the Air Force Material Command (AFMC) BAA: Mitigation Plans are not permitted in order to resolve OCI issues involving contracts awarded under the AFMC A&AS contract and the AFMC BAA.).

__________________________Signature) ________________________ (Date) (Authorized Official / Sr. Mgr / Officer)

_________________________Printed Name) ________________________ (Title)

APPENDIX B: HQ USAF/SG NON-DISCLOSURE AGREEMENT

REVISED: 30 AUG 2007

Purpose: The purpose of this Non-Disclosure Agreement (NDA) is to confirm in writing that the undersigned understands his/her responsibilities regarding protection of information and/or material that he/she may come in contact with in the course of work performed under this agreement. This NDA covers all forms of information made available as Government Furnished Information or information/material developed under this agreement, whether in the form of working materials or as deliverable product. This NDA applies to unclassified Government information/material, proprietary information/material supplied by other vendors for use by the Government, and classified Government information/material and is intended to supplement, not replace, the DD Form 254. All information/material released to the contractor remains the property of the US Government and may be withdrawn at any time.

Responsibility: As a condition of acceptability for work under this agreement with Air Force Material Command /773 ESS/PK on behalf of AF/SG, individuals are required to complete the attached NDA:

NON-DISCLOSURE AGREEMENT

FOR

CONTRACTOR/SUBCONTRACTOR EMPLOYEES, SENIOR MANAGERS OR

CORPORATE OFFICERS

(Agreement) I, ___________________________________________________________ (clearly print or type name), an employee, senior manager, or corporate officer of either _________________________ or a subcontractor to _____________________ under Prime Contract number ______________________; Task Order _____________________ awarded to ______________________ by the AF/SG office (Customer) agree not to disclose to any third party or anyone who is not performing work for the Customer and who does not have a need to know such information, any proprietary, source selection sensitive information, programmatic, or budgetary information (Information) contained in or accessible through the AF/SG programs and activities. Proprietary, programmatic, budgetary and source selection sensitive information and data will be handled in accordance with Government direction under the AF/SG program and applicable Government laws and regulations, including Federal Acquisition Regulation (FAR) Sections 3.104 and 9.5.

I understand that Information I may receive or possess, as a result of my assignment to work on AF/SG activities under this Contract may be considered proprietary, source selection sensitive information, and/or For Official Use Only. The responsibilities of my employer for the proper use and protection from unauthorized disclosure of proprietary or source selection sensitive information are described in FAR 3.104. Pursuant to FAR 3.104, I agree that I shall not appropriate such information for my own use or release or discuss such information with third parties unless specifically authorized by the procedures set forth in FAR 3.104.

This Agreement shall continue for a term of five (5) years from the date upon which I last have access to such information. Upon expiration of this Agreement, I have a continuing obligation not to disclose proprietary, programmatic, budgetary or source selection sensitive information to any person or legal entity unless that person or legal entity is authorized by the Government to receive such Information. I understand that any violation of my duty to protect proprietary or source selection sensitive information I was exposed to while working as an employee of _______________________ company working under the Prime Contract, subcontract, or task order as referenced above may subject me, and/or my employer, to administrative, civil and criminal sanctions.

I understand that the United States Government may seek any remedy available to it to enforce this Agreement, including, but not limited to, application for a court order prohibiting disclosure of information in breach of this agreement. Court costs and reasonable attorney fees incurred by the United States Government may be assessed against me if I lose such action. I understand that another company might file a separate claim against me if I have misused its proprietary information.

In the event that I seek other employment, I will reveal to any prospective employer the continuing obligation in this agreement prior to accepting any employment offer.

If signing as a corporate officer of either the Prime or Subcontractor, I certify that I am a duly authorized representative with legal authority to bind the Company.

Agreed and Accepted:

APPENDIX C: CUSTOMER COMPLAINT RECORD

CUSTOMER COMPLAINT RECORD

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

Customer Complaint Record Template, Feb 05 (SAF/AQCP) COMPLAINANT - 1

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

Customer Complaint Record Template, Feb 05 (SAF/AQCP) COR - 2

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

Customer Complaint Record Template, Feb 05 (SAF/AQCP) CONTRACTOR – 3

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

Customer Complaint Record Template, Feb 05 (SAF/AQCP) CONTRACT ADMINISTRATOR - 4 image1.emf