FINAL_PWS and PRS_19Jul23.pdf

Ver. October 2022

PERFORMANCE WORK STATEMENT (PWS)

FOR

Occupational Medical Examination Services 07/19/2023

1 General: Occupational medical examinations are performed for two distinct purposes:

Medical qualification-based on the requirements of the duty position

Medical surveillance-objective evaluation of potential or actual hazards or exposures in the duty location of the federal employee based on Industrial Hygiene Risk Assessment Surveys and random testing

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 Occupational Medical Examination Program Services, as defined in this PWS, to perform medical examinations annually for approximately 1000 California Army National Guard full time federal employees for baseline hiring, termination or transfer. Additionally, medical surveillance examinations to be completed annually based on work code and Industrial Hygiene (IH) Risk Assessment Codes (RAC). This requirement should not fluctuate below 300 or above 1000, annually. The government reserves the right to increase and/or decrease the number of employees requiring examinations, during the contract period, based on the requirement for medical services, as defined in this PWS.

1.1.1 Objectives: The purpose of the Occupational Medical Examination Program is to provide job-related Occupational Health Examinations and Medical Surveillance Services to approximately 300-1000 CA ARNG full-time federal technician support (FTS) and/or temporary personnel who are exposed to OSHA level PEL health hazards in the work environment. The examination shall include personnel assigned to positions requiring specific standards of physical fitness. Personnel not included under these examinations are State Employees, civilian contractors, Active Guard Reserve, Active Duty for Operational Support (ADOS) and part-time traditional Soldiers. This contract is to provide annual examinations to screen CA ARNG Federal employees for potential exposure to occupational workplace hazards and basic health.

1.2 Background: This contract is for “Non Personal” Health Care “Services”, as defined in FAR 37.101. In accordance with FAR Part 37.4 the Government may enter a non-personal health care services contract with physicians, dentists and other health care providers under authority of 10 U.S.C. 2304 and 41 U.S.C.

253.

1.2.1 Examinations are required for compliance with the following:

1.2.1.1 DoDM 6055.05, Occupational Medical Surveillance Manual

1.2.1.2 Army Regulation 11-34 The Army Respiratory Protection Program

1.2.1.3 29 CFR1910.120, Occupational Safety and Health Standards for Medical Surveillance

1.2.1.4 29 CFR 1960, Safety and Health Provisions for Federal Employees

1.2.1.5 ANSI 288.6-1884, American National Standards for respiratory protection, respirator use, & physical qualifications for personnel

1.2.1.6 Threshold Limit Values (TLVs) and Biological Exposure Indices, as established by the American Conference of Governmental Industrial Hygienists (ACGIH).

1.3 Period of Performance (PoP): The anticipated Period of Performance is from 01 July 2023 through 30 September 2027. Period of Performance shall be 1 Base Year of 12 months and four (4) 12-month option years.

1.4 General Information: Examinations are required annually for approximately 300-1000 CA ARNG full time employees. This requirement will not fluctuate below 300 or above 1000, annually. The government reserves the right to increase and/or decrease the number of employees requiring examinations, during the contract period, based on the requirement.

1.4.1 Place and Performance of Services: The contractor must maintain a facility within 200 mile radius of CA Army National Guard (CA ARNG) facilities located within the state of CA. Or provide Mobile services within 5 miles of the CA ARNG facilities. The Contractor must provide services between the hours of 0700-1630 on a typical duty week of Monday through Friday, except on recognized US holidays. The contractor shall always maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential. (Meaning at least one facility in each location) that provides Occupational Health Examinations.

1.4.2 Telework: Telework is not authorized.

1.4.1.2 Reserved

1.4.1.3 Reserved

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: January 1st

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: June 19th

1.4.2.6 Independence Day: July 4th

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.9 Veteran’s Day: November 11th

1.4.2.10 Thanksgiving Day

1.4.2.11 Christmas Day: December 25th

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 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. 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 Reserved.

1.4.5.1 Reserved.

1.4.5.1.1 Reserved.

1.4.5.1.2 Reserved.

1.4.5.1.3 Reserved.

1.4.5.1.4 Reserved

1.4.5.1.5 Reserved

1.4.5.1.5.1 Reserved.

1.4.5.1.6 Reserved.

1.4.5.2 Reserved

1.4.5.3 Reserved

1.4.5.4 Reserved

1.4.5.5 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.

1.4.5.6 Reserved.

1.4.5.6.1 Reserved.

1.4.5.6.2 Reserved.

1.4.5.6.3 Reserved.

1.4.5.6.4 Reserved.

1.4.5.6.5 Reserved.

1.4.5.7 Reserved.

1.4.5.8. Reserved.

1.4.5.9 Reserved.

1.4.5.10 Protection of Personally Identifiable Information (PII) and Personal Health Information (PHI). 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 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.

Contractor will also ensure all health information is safeguarded in accordance with federal regulations.

1.4.5.11 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees 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 (if no COR is assigned, delete to the COR and replace with to the KO) within 15 calendar days after completion of training. Level 1 OPSEC training is available at https://securityawareness.usalearning.gov/opsec/index.htm.

1.4.6 Reserved

1.4.6 Reserved

1.4.6.1.1 Reserved

1.4.6.1.2 Reserved

1.4.6.1.3 Reserved

1.4.6.2 Reserved

1.4.7 Special Qualifications: The contractor shall ensure all employees possess all required licenses for OHSA Occupational Health Exams. 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 https://securityawareness.usalearning.gov/opsec/index.htm training to contractors. Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified, and otherwise qualified to provide services.)

1.4.8 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 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.

1.4.10.1 Reserved

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 any form 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 Contractor Travel if awarded to a traveling medical company during the performance of this contract to perform medical examination shall be to the following locations:

Riverside, CA

Los Alamitos, CA

Sacramento, CA

San Luis Obispo, CA

Redding, CA

If a contractor travel company is awarded the contract, 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.

1.4.13 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 the 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.

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

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 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.

2.1.5 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 an end product or service shall meet contract requirements.

2.1.9 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 Infostructure AR Army Regulation AT/OPSEC Antiterrorism/Operational Security BI Background Investigation CM Contract Manager CA ARNG California Army National Guard 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 DSCA Defense Counterintelligence and Security Agency FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services HQDA Headquarters, Department of the Army HSPD Homeland Security Presidential Directive IA Information Assurance IS Information System(s) KO Contracting Officer NGB National Guard Bureau OCI Organizational Conflict of Interest 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

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: Reserved

3.2 Materials: Reserved

3.3 Equipment: Reserved

3.4 Services: Reserved

3.5 Utilities: Reserved

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E)

4.1 General: Except for those items specifically stated to be Government-Furnished- the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

4.2 Reserved

4.3 Reserved

5.0 Requirements: The contractor shall be in the primary business of, or have an agreement with an entity that is in the primary business of, conducting Occupational Health Exams at a facility within a 200-mile radius of CA ARNG facility. The contractor shall be compliant with HIPAA, Privacy Act, OSHA & ADA. Contractor shall provide Medical Qualification Examinations based on the requirements of the duty position, for onboarding/baseline exams, transfer/retirement/termination exams. Provide medical Surveillance Examinations for Federal employees that have potential or actual hazards or workplace exposures or Federal Job Code/Title as determined by the Occupational Health Nurse, DoD and Army regulations. The Contractor will provide all required examinations.

5.1 Scheduling of Examinations:

5.1.1 A Contracting Office Representative (COR) from the CA ARNG Safety & Occupational Health (SOH) Office will work with the contractor to provide best estimates of the forecasted number of employees that require an examination at each place of performance.

5.1.2 Prior to scheduling, the COR will provide the contractor with a list of employees requiring examinations. The list will include place of employment, full name, location the examination is required, and specific type of examination(s) required.

5.1.3 The supervisor of the employee(s) will then contact the contractor, or their designated POC at the examination facility, at least five (5) days in advance to schedule the examination. The contractor will make every effort to accommodate scheduling requests from the supervisor. The contractor will notify the supervisor about any requirements the employee must comply with, prior to the examination, such as fasting.

5.1.4 The contractor will provide the CA ARNG SOH Office COR a list of the scheduled examinations at least two (2) days prior to any examinations. The list will include the employee’s place of employment, full name, location the examination is scheduled, specific type of examination(s) scheduled, and the date/time of the examination.

5.1.5 Examinations will only be provided for employees that have been previously approved. Any employee not previously approved by both the contractor and the CAARNG SOH Office COR will not receive an examination.

5.1.6 Invoicing. The contractor will upload a monthly invoice, for all services performed under this contract, to the Wide Area Workflow (WAWF) Website and will send an electronic copy to the COR in the CA ARNG SOH Office.

5.1.7 Employees identified by the OHN will require an annual examination. On average this will be 200 employees, annually and this number will not drop below 200 or exceed 500.

5.1.8 Medical Surveillance Procedures. Medical Surveillance procedures may consist of the following:

5.1.8.1 Audiogram. Audiograms will be completed based on an employee’s work environment/medical history. On average 200 employees will require an audiogram, annually. This number will not drop below 100 or exceed 400. If test results are questionable repeat hearing testing will be accomplished at no additional cost to the government.

Audiometric equipment will be tested and calibrated per OSHA/ANSI standards to include -daily “functional operation” test before each day’s use (listening test and an electronic biological check); annual acoustic and exhaustive testing and calibration by a certified specially trained individual or appropriate laboratory.

5.1.8.2 Respirator Evaluation. Respirator Fit Testing will be required for employees who wear a respirator or based on an employee’s work environment/medical history. On average 350 employees will require a Respirator Evaluation, annually. This number will not drop below 100 or exceed 500.Quantitative Fit Testing will be performed using masks/respirators assigned to and brought to the examination facility by the employee.

5.1.8.3 If an employee fails the Respirator Fit Test, a spirometry test will be required.

5.1.8.4 Spirometry testing will: Be performed by a licensed physician, Certified Pulmonary

Function Technologist, or Registered Respiratory Therapist in accordance with 29 CFR

1910.1001. Include Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC) Ratio. Results will be normalized (adjusted for height and weight, sex, race, age factors) and compared against predicted norms with a documented interpretation by a pulmonologist or certified Occupational Health physician.

5.1.8.5 Be acceptable with at least three (3) maneuvers free from a leak, obstructed mouthpiece, hesitation, false starts, cough, glottis closure, early termination, and have a good curve of at least 6 seconds in duration. Be considered repeatable when the two (2) largest FVCs are within 0.150 L of each other and two (2) largest FEV1's are within 0.150 L of each other. If three (3) acceptable and two (2) repeatable tests cannot be obtained the reason the standard could not be met should be documented. Testing is complete when criteria are met, 8 trials are attempted, or the employee being tested cannot or should not continue.

5.1.8.6 Prior to testing the contractor shall verify that the employee has not smoked or used an inhaler in the last hour and that they don’t have any cold, flu, or allergy symptoms that will affect their performance during the test. Fit Testing: Test results should include quantitative results, the type and size of respirator, name and title of the individual performing the test.

Spirometry: Test results, type of machine used to perform the test, name and title of the individual conducting the test.

5.1.8.7 Lead and Heavy Metal Screening. The following procedures will be completed as part of this exam: Blood Lead Level and Zinc Protoporphyrin (ZPP), Cadmium and Chromium Testing. Lead screening is required for employees identified as having a heightened exposure to lead. On average 15 employees will require a Lead Screening, annually. This number will not drop below 5 or exceed 50. If during the examination the examining physician determines an employee should receive the Lead Screening Procedure, prior to the procedure the contractor shall call the CA ARNG SOH COR to explain why and receive approval for the procedure. If the CA ARNG SOH COR is not reached the contractor shall leave a phone message with the employee’s name and the location of the examination, then proceed with the procedure.

5.1.8.8 Chest X-Rays. This procedure includes posterior and anterior (PA) and lateral view Chest X-Rays. Chest X-Rays are required only if deemed necessary by the examining physician or CA ARNG SOH Office, because of exposure to cadmium or asbestos at or above the OSHA time weighted average and/or excursion limit. There is no average or minimum number of chest x-rays required. The maximum number of x-rays will not exceed 50. X- Rays will be performed by a certified X-ray technician and be interpreted and classified by a B-reader, or a board eligible or certified radiologist meeting the requirements of 29 CFR

1910.1001 Appendix E.

5.1.8.9 If during the course of the examination the examining physician determines an employee should receive Chest X-Rays, prior to the X-Rays the contractor shall call the CA ARNG SOH COR or OHN to explain why and receive approval for the procedure. If the CA ARNG SOH COR or OHN are not reached the contractor shall leave a phone message with the employee’s name and the location of the examination, then proceed with the procedure.

5.1.8.10 Lab Results. Copies of the lab results will be provided to the employee after the services are provided or immediately upon availability.

5.1.8.11 Examination Results. All examination results and paperwork shall be submitted to the CA ARNG SOH COR not later than 15 days after the examination. Electronically transmitting examination results to the CA ARNG SOH COR is the preferred method.

5.1.8.12 This will be part of the evaluation criteria when evaluating quotes for contract award.

Results should include a copy of the original/approved list (see para 3.2.4.) showing the employees place of employment, full name, location the examination is scheduled specific type of examination(s) scheduled, and the date/time of the examination.

5.1.8.13 All paperwork should be separated/segregated by employee. There may be a non-routine requirement to conduct a baseline examination for new employees. For new employees, these examination results shall be received not later than 5 days of the examination. The CA ARNG SOH COR will identify any employees who are receiving preliminary examinations in the initial request (see para 3.2.2.). If the results of an examination would typically result in a clinician following up/making recommendations to a patient, that follow up/recommendation shall be included with the examination results. The follow up/recommendation shall be explained in “laymen terms” understandable to someone without specialized medical training and include an explanation of why the follow up/recommendation is being made.

5.1.9 Scope of Work: This is a three-phase requirement. Phase one will be setup of the contract;

including establishment of procedures used to provide examinations. Phase two will be execution of the contract, including conducting, invoicing, and completion/submission of documentation for the required examinations. Phase three will be closeout of all delivery orders, including disposition of records and final payment.

5.1.10 Phase One. Within 30 days of receipt of contract award, the contractor will work with the COR in the CA ARNG SOH Office to:

5.1.10.1 Identify facilities where examinations will be conducted, in each city.

5.1.10.2 Provide verification, in writing, that all personnel associated with the contract have received all required training and credentialing required through the federal government and State of CA to provide the services required under the contract.

5.1.10.3 Confirm receipt of all required forms to be filled out for employees receiving examinations.

5.1.10.4 Provide phone and email contact information for a “project manager” with the contractor and representatives at each of the facilities where examinations will be performed.

5.1.11 Phase Two. During the timeframe that examinations are occurring, the contractor will:

5.1.11.1.1 Schedule all required examinations

5.1.11.1.2 Conduct all required examinations

5.1.11.1.3 Provide copies of all examination paperwork

5.1.11.1.4 Notify the CA ARNG SOH Office within 1 day of becoming aware that a facility, where examinations are provided, has or is predicted to have:

5.1.11.1.4.1 Determined that results of the medical examination are of critical significance/importance and/or require immediate/life threatening care.

5.1.11.1.4.2 A problem that will prevent scheduled examinations from occurring within 24 hours

5.1.11.1.4.3 A problem involving any CA ARNG employee who

has received services related to this contract.

5.1.11.1.4.4 A lack of qualified medical personnel to support the requirements of this contract.

5.1.11.1.4.5 Any “no-show” by a CA ARNG employee for a

scheduled examination.

5.1.11.1.5 Invoice against this contract, as specified in para3.

5.1.12 Phase Three. Upon completion of all examinations and the specified period of performance, the contractor will:

5.1.12.1.1 Ensure copies of all examination records have been provided to the CA ARNG SOH COR

5.1.12.1.2 Submit a final invoice for all examinations, not previously invoiced.

5.2 Additional Contractor Responsibilities. The contractor shall:

5.2.1 Ensure that all personnel performing services related to this contract are properly trained, certified, and licensed as required by the federal government and State of California.

5.2.2 Maintain medical liability insurance for no less than the amount normally prevailing within the local community for the examinations required under this contract.

5.2.3 Ensure a Board eligible or Certified Occupational Medicine Physician conducts all job-related medical surveillance physical examinations and occupational health consultation services.

5.2.4 Ensure proper testing and calibration of all equipment required to complete these examinations.

Supporting documentation for all testing and calibration will be provided to the CAARNG Contracting Office or CA ARNG SOH COR, if requested.

5.2.5 Ensure all procedures are conducted in accordance with applicable American Board of Occupational and Environmental Medicine (ABOEM), American Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) Standards.

5.2.6 Ensure all laboratory tests are performed by personnel certified under the American Society of Clinical Pathology and processed by certified clinical laboratories 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 Pathologies.

5.2.7 Ensure licensed medical technicians perform the Medical Surveillance Examination screening/testing elements. Personnel conducting audiograms must be certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC). Personnel conducting spirometry shall be certified through a program approved by the National Institute for Occupational Safety and Health (NIOSH).

5.2.8 Ensure all subcontractors are provisioned for health care services, including the requirements of clause 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance.

5.2.9 Ensure all sharp instruments, blood, and urine is handled and disposed of in accordance with federal, state, and local regulations, 100% of the time.

5.2.10 Not be entitled to any separate travel or per diem costs. Any travel requirements shall be addressed in the contractor’s proposal prior to any contract award.

5.2.11 Perform only those services covered by the contract and this PWS, and only during periods covered by the Contract. If any services not included in this contract are received by a CA ARNG employee or provided by a contractor’s facility, those services shall not be charged against this contract.

5.2.12 Ensure any services received by a CAARNG employee or provided by a contractor’s facility, not included in this contract, are paid for by the CA ARNG employee and that the employee is aware they will be responsible for payment before the service is provided.

5.2.13 Provide services in a professional manner throughout the period of performance.

5.2.14 Indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance.

5.2.15 Ensure all records with employee Personally Identifiable Information (PII) and Personal Health

Information (PHI) are safeguarded, in accordance with federal regulations.

5.2.16 With regards to examinations:

5.2.16.1 Employees will not typically be asked to bring any case history or medical paperwork with them to examinations.

5.2.16.2 Employees arriving within 30 minutes of their scheduled appointment time should receive their examination. After 30 minutes, an employee may be rescheduled.

5.2.16.3 Examinations will typically be scheduled Monday – Friday between the hours of 0700 – 1630.

5.2.16.4 All examinations should be completed in one (1) day.

5.2.16.5 Destroy all contract/exam related paperwork upon completion of contract

5.3 Service Contract Reporting:

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 National Guard Bureau via a secure data collection site.

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

https://sam.gov . Log in and select Entity Registrations and then select Service Contract Reporting.

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/ https://dodprocurementtoolbox.com/site-pages/service-contract-reporting-scr 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 Publicatio n

Mandatory or Advisory

Website

DoDM 6055.05 07/27/2022 Mandatory https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/do dm/605505m.PDF?ver=3u-UoR7v7wydz-RIKQkI_Q%3d%3d

DoDI 6055.01 04/21/2021 Mandatory https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/do di/605501p.pdf?ver=9w5ACMyAR4HKrYamZVQY7w%3d%3d

AR 11-34 07/25/2013 Mandatory https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?

PUB_ID=67365

Federal Acquisition Regulation N/A Mandatory https://www.acquisition.gov/browse/index/far

Title 29, Code of Federal Regulations, Part 1910:

Occupational Safety and Health Standards

03/07/2018 Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1910

Title 29, Code of Federal Regulations, Part 1960:

Safety and Health Provisions for Federal Employees

11/26/2004 Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1960

Threshold Limit Values and Biological Exposure Indices (TLVs), American Conference of Governmental Industrial Hygienists (ACGIH), Cincinnati, Ohio

12/08/2018 Mandatory https://www.osha.gov/annotated-pels

Army Regulation 40-5, Preventive Medicine

05/12/2020 Mandatory https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?

PUB_ID=1006800

U.S. Department of Labor, Code of Federal Regulations 29 (CFR) 1910.120 (b) (5), (f), Medical Surveillance

10/04/2016 Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.120

Headquarters, Department of the Army Pamphlet (DA PAM) 40-501 Hearing Conservation

01/08/2015 Mandatory https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?

PUB_ID=68571

DoD 5400.11-R Department of Defense Privacy Program

05/14/2007 Mandatory https://www.esd.whs.mil/Directives/issuances/dodm/

DoDD 8140.01 Cyberspace Workforce Management

10/05/2020

Mandatory https://www.esd.whs.mil/Directives/issuances/dodd/

DoD 8570.01-M Information Assurance Workforce Improvement Program

12/19/2005 (Change 4:

11/10/2015)

Mandatory https://www.esd.whs.mil/Directives/issuances/dodm/

DoD 5220.22-M 02/28/2006 (Change 2:

05/18/2016) https://www.fsd.gov/ https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodm/605505m.PDF?ver=3u-UoR7v7wydz-RIKQkI_Q%3d%3d https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodm/605505m.PDF?ver=3u-UoR7v7wydz-RIKQkI_Q%3d%3d https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/605501p.pdf?ver=9w5ACMyAR4HKrYamZVQY7w%3d%3d https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/605501p.pdf?ver=9w5ACMyAR4HKrYamZVQY7w%3d%3d https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=67365 https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=67365 https://www.acquisition.gov/browse/index/far https://www.osha.gov/laws-regs/regulations/standardnumber/1910 https://www.osha.gov/laws-regs/regulations/standardnumber/1910 https://www.osha.gov/laws-regs/regulations/standardnumber/1960 https://www.osha.gov/laws-regs/regulations/standardnumber/1960 https://www.osha.gov/annotated-pels https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=1006800 https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=1006800 https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.120 https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.120 https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=68571 https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=68571 https://www.esd.whs.mil/Directives/issuances/dodd/ https://www.esd.whs.mil/Directives/issuances/dodm/

National Industrial Security Program Operating Manual

(NISPOM)

Army Directive 2014-05 Policy and Implementation Procedures for Common Access Card Credentialing and Installation Access for Uncleared Contractors

03/07/2014 Mandatory https://armypubs.army.mil/ProductMaps/PubForm/ArmyDir.aspx

AR 25-2

04/04/2019

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 525-13

Antiterrorism

12/09/2019 Mandatory http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 381-12

Threat Awareness and Reporting Program (TARP) (Section II, ¶ 2-4.b)

06/01/2016 Mandatory http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

Defense Federal Acquisition Regulation Supplement

N/A Mandatory http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html or https://www.acquisition.gov/dfars

Joint Travel Regulation (JTR) N/A Mandatory https://www.defensetravel.dod.mil/site/travelreg.cfm

DoDM 1000.13-M-V1 DoD Identification (ID) Cards (Enclosure 2, paragraph 3.b)

01/23/2014 (Change 1:

07/28/2020)

Mandatory http://www.esd.whs.mil/Directives/issuances/dodm

Federal Information Processing Standards (FIPS) Publication 201-2 Personal Identity Verification (PIV) of Federal Employees and Contractors (paragraph 9)

August 2013 Mandatory http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf

DoDM 5200.2 Procedures for the DoD Personnel Security Program (PSP)

04/03/2017 Mandatory https://www.esd.whs.mil/Directives/issuances/dodm/

DoDI 5200.46 DoD Investigative and Adjudicative Guidance for Issuing the Common Access Card (CAC)

09/09/14 (Change 1:

05/04/2018)

Mandatory https://www.esd.whs.mil/Directives/issuances/dodi/

Homeland Security Presidential Directive (HSPD)- Policy for a Common Identification Standard for Federal Employees and Contractors

08/27/2004 Mandatory https://www.dhs.gov/homeland-security-presidential-directive-12

DoDI 5400.11 Department of Defense Privacy and Civil Liberties Programs

01/29/2019

Mandatory https://www.esd.whs.mil/Directives/issuances/dodi/

DoD 5400.11-R Department of Defense Privacy Program

05/14/2007 Mandatory https://www.esd.whs.mil/Directives/issuances/dodm/

DoDD 8140.01 Cyberspace Workforce Management

10/05/2020

Mandatory https://www.esd.whs.mil/Directives/issuances/dodd/

DoD 8570.01-M

Workforce Improvement Program

12/19/2005 (Change 4:

11/10/2015)

DoD 5220.22-M National Industrial Security Program Operating Manual

(NISPOM)

02/28/2006 (Change 2:

05/18/2016)

Army Directive 2014-05 03/07/2014 Mandatory https://armypubs.army.mil/ProductMaps/PubForm/ArmyDir.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html https://www.acquisition.gov/dfars http://www.esd.whs.mil/Directives/issuances/dodm http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.esd.whs.mil/Directives/issuances/dodd/

Policy and Implementation Procedures for Common Access Card Credentialing and Installation Access for Uncleared Contractors

AR 25-2

04/04/2019

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 525-13

Antiterrorism

12/09/2019 Mandatory http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AR 381-12

Threat Awareness and Reporting Program (TARP) (Section II, 2-4.b)

06/01/2016 Mandatory http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx

AFI 10-245

Antiterrorism

03/28/2013 (Certified current 03/30/2017)

Mandatory https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series=- 1&modID=449&tabID=131

AFI 31-101

Security Forces Standards and Procedures

08/18/2020 Mandatory https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series=- 1&modID=449&tabID=131

AFMAN 31-113

Security Forces Standards and Procedures

03/05/2013 Change 1:

12/02/2015

Mandatory https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series=- 1&modID=449&tabID=131

AFPD 17-1

Information Dominance Governance and Management

04/12/2016 Mandatory https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series=- 1&modID=449&tabID=131

AFMAN 17-1301

Computer Security

(COMPUSEC)

02/12/2020 Mandatory https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series=- 1&modID=449&tabID=131

AFI 10-701

Operations Security

7/24/2019 (Change 1:

06/09/2020)

Mandatory https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series=- 1&modID=449&tabID=131

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

Form Date Website

OF 178

Certificate of Medical Examination

Apr 2021 https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodm/6055 05m.PDF?ver=3u-UoR7v7wydz-RIKQkI_Q%3d%3d

DD 441

Department of Defense Security Agreement

Feb 2020 http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm

DD 250

Material Inspection and Receiving Report

Aug 2000 https://www.esd.whs.mil/Directives/forms/dd0001_0499/ http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodm/605505m.PDF?ver=3u-UoR7v7wydz-RIKQkI_Q%3d%3d https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodm/605505m.PDF?ver=3u-UoR7v7wydz-RIKQkI_Q%3d%3d http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm https://www.esd.whs.mil/Directives/forms/dd0001_0499/

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).

Performance Objective Performance Standard Acceptable Quality

Levels (AQL)

Surveillance Method / by

Whom

1. 5.0 Provided all required examinations

Able to support all employees requiring an examination

Meets the standard 100% of the time.

Periodic Inspection/COR

2. 1.4.12 Provided examinations in required locations

Able to provide examinations @ all sites specified

Meets the standard 100% of the time

Random Inspection/COR

3. 5.1.4 Responds to requests for exams from SOH Office & Supervisors in timely manner

Schedules & notifies of all exams/changes within 48 hours of receipt

Meets the standard 100% of the time

Periodic Inspection/COR

4. 5.1.5 Only provides exams to approved employees

Only provides/charges for exams to approved employees

Meets the standard 100% of the time

Periodic Inspection/COR

5. 5.1.6 Upload invoices to WAWF & submit to SOH Office

Provides invoices monthly via email and via postal service

Meets the standard 100% of the time

Monthly by COR

6. 5.0 and 5.2.11 Provides only exam services as specified in para 5.0

Provides all annual exam, resp eval, lead scrng, chest x-rays

Meets the standard 100% of the time

Periodic Inspection/COR

7. 6.1 Use of CA ARNG specified forms for annual examinations

Uses forms specified for annual exams Meets the standard 100% of the time

Periodic Inspection/COR

8. 5.1.10.3 Use of proprietary forms for additional procedures, as required.

Uses forms designed for listed procedures that are easy to understand

Meets the standard 100% of the time

Periodic Inspection/COR

9. 5.1.8.1 and 5.2.4 Proper testing of equipment

Test equipment is working properly Meets the standard 100% of the time

Periodic Inspection/COR

10. 5.1.8.7 and 5.1.8.9 AS REQUIRED properly screen/refer employees for respirator eval, lead screening, chest x-rays

Additional procedures are ordered by medical provider only if deemed necessary based on history/exposure to cadmium, lead, or asbestos.

Meets the standard 100% of the time

Periodic Inspection/COR

11. .5.1.8.8 Receive approval for spirometry tests, lead screening & chest x-rays prior to approving procedure

Contacts SOH/COR office prior to lead screening or chest x-rays, unless previously approved

Meets the standard 100% of the time

Periodic Inspection/COR

12. 5.1.8.4 Spirometry procedure properly conducted and documented

Conducted by appropriate personnel as specified

Meets the standard 100% of the time

Periodic Inspection/COR

13. 5.1.8.2 Respirator Fit Test properly conducted/documented

Conducted as specified Meets the standard 100% of the time

Periodic Inspection/COR

14. 5.1.8.8 X-Rays properly performed/interpreted

Performed by x-ray tech & interpreted/classified by B-reader or radiologist

Meets the standard 100% of the time

Periodic Inspection/COR

15. 1.4.7 and 5.2.1 Training/Credentialing of personnel providing services

All personnel providing services shall be properly trained, licensed, and/or certified

Meets the standard 100% of the time

Periodic Inspection/COR

16. 1.4.9 Provide a POC for all services provided @ all facilities

Provide SOH office with current POCs Meets the standard 100% of the time

Periodic Inspection/COR

17. 5.1.11.1.4 Notify the SOH office within 24 hours of events specified

Notify SOH Office when a listed problem comes up

Meets the standard 100% of the time

Periodic Inspection/COR

18. 5.1.12.1.1 and 5.1.8.10

Provide copies of all examination paperwork to the employee & SOH office, as required.

Copies of all paperwork to the employee & SOH Office

Meets the standard 100% of the time

Periodic Inspection/COR

19. 5.2.16.5 Destroy all contract/exam related paperwork upon completion of contract

Destroy all related paperwork Meets the standard 100% of the time

Periodic Inspection/COR

20. 5.2.2 Maintain medical liability insurance as required by law

Properly maintain insurance Meets the standard 100% of the time

Periodic Inspection/COR

21. 5.2.9 Proper disposal of sharp instruments, blood, urine

Properly dispose of hazardous equipment & substances

Meets the standard 100% of the time

Periodic Inspection/COR

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference /

Deliverable Title

Frequency Number of Copies

Medium/Format Submit

To

5.1.16 Hard copy Original Exam

Provide within 15 calendar days after employee exam.

1 Original Paper Copy

COR

5.1.16 Digital copy Original Exam

Email COR within 15 days after employee exam

1 Digital COR

TECHNICAL EXHIBIT 3

Estimated Workload Data

This information is provided for historical background only. It is not a guarantee of workload quantities.

ITEM NAME ANNUAL ESTIMATED QUANTITY

1 California 800

7.0 Attachments:

7.1 Attachment 1: Wage Determinations