NVARNG Occ Health Exams PWS.pdf

PDF 159 KB Posted May 13, 2021

Attached to: Nevada Army National Guard Occupational Health Physical Exams
Solicitation number: W9124X21Q0017
Issued by: Department of the Army Nevada Army National Guard

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File	Type	Posted
Amendment 0001 SF30 RFQ W9124X21Q0017.pdf	PDF	May 25, 2021
SF1449 W9124X21Q0017.pdf	PDF	May 13, 2021

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Ver. January 2021

PERFORMANCE WORK STATEMENT (PWS)

FOR

Occupational Medical Surveillance Examination Services

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Occupational Medical Surveillance Examination Program Services, as defined in this PWS.

1.1.1 Objectives: The purpose of the Occupational Medical Surveillance Examination Program is to provide job-related Occupational Health Examinations and Medical Surveillance Services to approximately 300 NVARNG full-time 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.

1.2 Background: This contract is for “Non Personal” Health Care “Services”, as defined in 37.101. In accordance with FAR Part 37.4 the Government may enter into 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.

1.3 Period of Performance (PoP): The anticipated Period of Performance is from 01 July 2021 through 30 June 2022.

1.4 General Information:

1.4.1 Place and Performance of Services: Contractor must maintain a facility within the 50 mile radius that provides Occupational Health Exams.

1.4.1.1 Telework: Not Applicable.

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 will not be requested to perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King, Jr.’s Birthday

1.4.3.3 President’s Day

1.4.3.4 Memorial Day

1.4.3.5 Independence Day: July 4th

1.4.3.6 Labor Day

1.4.3.7 Columbus Day

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day

1.4.3.10 Christmas Day: December 25th

1.4.3 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.

1.4.5.1.3 Reserved.

1.4.5.1.4 Reserved.

1.4.5.1.5.1 Reserved.

1.4.5.1.6 Reserved.

1.4.5.5 Reserved.

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.

1.4.5.10 Protection of Personally Identifiable Information (PII). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

1.4.5.11 Reserved.

1.4.6 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 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, Linda Winslow, 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.

1.4.11. Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at

FAR 22.17.

1.4.13 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 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: Not Applicable.

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 COR Contracting Officer Representative DA Department of the Army DD254 Department of Defense Contract Security Classification Specification DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services 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 PHA Physical Health Assessment 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: None

3.2 Materials: None

3.3 Equipment: None

3.4 Services: None

3.5 Utilities: None

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

4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

5.0 Requirements: The contractor shall:

5.1 The contractor must provide the following Medical Surveillance Examinations to NVARNG federal employees that are exposed to toxic workplace hazards: baseline exams, periodic health exams and termination exams. The contractor must be compliant with HIPAA, Privacy Act, OSHA & ADA.

5.2 Provide the following physical exam types:

Occupational Health Audiogram and Vision for approximately 180 personnel.

Occupational Health Full Physical Exam (H&P) for approximately 120 personnel.

5.2.1 Provide additional exams and laboratory tests as required:

Electrocardiogram (EKG)

Spirometry

FOH Profile including: Lipid panel, Bili (direct), GGT, LD, ALT, glucose, BUN, creat, GFR, BUN/creat ratio, Na, K, Cl, Ca, total protein, albumin, globulin, albumin/globulin ratio, bili (total), Alk Phos, AST, (CBC with diff & plt), UA

Lead, industrial whole blood

ZPP, Blood Protoporphyrins, zinc

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

Publication (Chapter/Page)

Date of Publication

Mandatory or Advisory

Website

Federal Acquisition Regulation https://www.acquisition.gov/?q=browsefar Defense Federal Acquisition

Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/current/in dex.html or https://www.acquisition.gov/dfars Joint Travel Regulation (JTR) 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) 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 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 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) https://www.esd.whs.mil/Directives/issuances/dodi/

Homeland Security Presidential Directive (HSPD)-12

Policy for a Common Identification Standard for Federal Employees and

Contractors

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

DoDI 5400.11 Department of Defense Privacy and

Civil Liberties Programs

01/29/2019 https://www.esd.whs.mil/Directives/issuances/dodi/

DoD 5400.11-R Department of Defense Privacy

Program

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

DoDD 8140.01 Cyberspace Workforce Management

10/05/2020 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) https://www.esd.whs.mil/Directives/issuances/dodm/

DoD 5220.22-M National Industrial Security Program

Operating Manual (NISPOM)

02/28/2006 (Change 2:

05/18/2016) https://www.esd.whs.mil/Directives/issuances/dodm/

Army Directive 2014-05 Policy and Implementation

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

03/07/2014 https://armypubs.army.mil/ProductMaps/PubForm/A rmyDir.aspx

AR 25-2

Information Assurance

04/04/2019 http://armypubs.army.mil/ProductMaps/PubForm/AR .aspx

AR 530-1

Operations Security

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

AR 525-13

Antiterrorism

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

Title 29, Code of Federal Regulations, Part 1910: Occupational Safety and

Health Standards

03/07/2018 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 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 https://www.osha.gov/annotated-pels

Army Regulation 40-5, Preventive Medicine

05/12/2020 https://armypubs.army.mil/ProductMaps/PubForm/Detail s.aspx?PUB_ID=1006800

Department of Defense 6055.05M, Occupational Medical Surveillance

Manual

05/02/2007 (Change 3:

08/31/2018) https://phc.amedd.army.mil/topics/workplacehealth/ih/Pa ges/Regulations-and-Policy.aspx

U.S. Department of Labor, Code of Federal Regulations 29 (CFR) 1910.120

(b) (5), (f), Medical Surveillance

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

Army Regulation 11-34, The Army Respiratory Protection Program

07/25/13 https://armypubs.army.mil/ProductMaps/PubForm/Detail s.aspx?PUB_ID=67365

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

Conservation

01/08/2015 https://armypubs.army.mil/ProductMaps/PubForm/Detail s.aspx?PUB_ID=68571

Headquarters, Department of the Army Pamphlet (DA PAM) 40-506 Vision

Conservation

07/15/2009 https://armypubs.army.mil/ProductMaps/PubForm/Detail s.aspx?PUB_ID=78813

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

Form Date Website

DD 1172-2

Application for Identification Card/DEERS Enrollment

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

I-9 10/21/2019 https://www.uscis.gov/sites/default/files/files/form/i-9.pdf

Performance Objectives Rate Comments Required Fix

1. Provides all required examinations Green No Comment Required for Green Yellow

Red

2. Provide Examinations in required Locations