PWS_Nurses.pdf

Ver. Oct 2022

PERFORMANCE WORK STATEMENT (PWS)

FOR

MAINE ARMY NATIONAL GUARD YOUTH CAMP MEDICAL SERVICES

1.0 General: The Maine Army National Guard (MEARNG) intends to host a Youth Camp to provide training and resources for military youth in the State of Maine per guidance in

AR 600-12.

1.1 Scope: The contractor shall provide two Registered Nurses, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph

3.0 as Government Furnished, to perform Medical Services, as defined in this PWS.

Within 14 days of contract award, contractor will be provided National Guard Bureau Background forms that must be filled and returned to government POC for each nurse conducting services.

1.2 Background: The Maine Army National Guard (MEARNG) Child & Youth Program intends to conduct their annual Youth Camp to provide training and resources for military youth in the State of Maine per guidance in AR 600-12. The camp consist of approximately 50 adults with 100 campers per week.

1.3 Period of Performance (PoP): The Period of Performance shall be July 8-21, 2023.

1.4 General Information: Sleeping quarters will be provided in the admin staff building which is in the same building as the medical office. Meals will be provided except for Saturday of each week, Friday lunch/dinner, and Sunday breakfasts. Options for meals not provided: local restaurants in the area, local grocery store, on-site kitchen to prepare personally procured subsistence.

1.4.1 Place and Performance of Services: The contractor shall provide services between the hours of 0700 (7 am) – 2100 (9 pm) with on-call availability 24/7. Performance shall be at Bog Brook Training Area Administrative Building, Gilead, Maine. The contractor shall at all times 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.

1.4.1.1 Telework: Telework is not authorized.

1.4.1.2 Reserved

1.4.1.3 The contractor’s employees shall become familiar with and obey the regulations of the installation, including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. The contractor shall ensure compliance with all regulations and orders of the installation, which may affect performance. The

Government reserves the right to direct the removal of an employee from Government property or revoke access to Government systems for misconduct, security reasons, or any overt evidence of communicable disease. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

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.

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

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

1.4.6.1 Key Control. Keys are anticipated to be issued to contractor employees. If keys are issued, the contractor shall establish and implement methods of ensuring all keys/key cards issued by the Government are not lost or misplaced and are not used by unauthorized persons. No keys issued by the Government shall be duplicated. The contractor shall include procedures covering key control in the QC Plan. The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the onsite Government POC.

1.4.6.1.1 The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the COR.

1.4.6.1.2 In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon direction by the KO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re- keying.

When the Government replaces or re-keys the locks, the Government will deduct the total cost of lock replacement or re-keying from the monthly payment due the contractor. In the event a master key is lost or duplicated, the Government will replace all locks and keys for that system and will deduct the total cost from the monthly payment due the contractor.

1.4.6.1.3 The contactor shall prohibit the use of the Government issued keys/key cards by any persons other than the contractor’s employees. The contractor shall prohibit the opening of locked areas by contractor employees to permit entrance of persons other than contactor employees engaged in the performance of services in those areas, or personnel authorized entrance by the KO.

1.4.6.2 Lock Combinations: The contractor shall establish and implement methods of ensuring that no lock combinations are revealed to unauthorized persons. The contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the contractor’s QCP.

1.4.7 Special Qualifications: The contractor shall ensure all employees possess all required licenses for performing as Registered Nurses at a youth camp. 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 contractor’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 provide 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 (by email is acceptable). 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 Government POC to resolve issues, receive directions 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: Contractor personnel will be required to wear camp T-shirts in the performance of this contract while on campus. Two shirts will be provided. One will be laundered daily. Sizes must be provided to Government POC before period of performance starts. All contractor personnel working 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’s status as a “contractor” shall be predominantly displayed in all correspondence and dealings with Government or non- Government entities.

1.4.10.1 The contractor shall retrieve all identification media (including vehicle passes) from its employees who depart employment for any reason. The contractor shall return all identification media (i.e., badges and vehicle passes) to the KO within 14 days of an employee’s departure.

1.4.11 Combatting 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 and the actions that will be taken against employees for violations of this policy.

The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.

1.4.12 Reserved

1.4.13 Reserved

1.4.14 Reserved

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 assure 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 Requirement List 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 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 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: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include desk space, telephones and other items necessary to maintain an office environment.

3.2 Materials:

OTC Medications

Item Item 3oz medication cups Cough/Cold medicine (Dayquil) Acetaminophen (Tylenol) 500 mg Children’s nighttime cough medicine Acetaminophen Children’s (Tylenol) (160mg tsp liquid)

Cough drops

Acetaminophen Children’s (Tylenol) (80mg chewable)

Diphenhydramine (Benadryl)

After bite Diphenhydramine Children’s Liquid (Benadryl) Aspirin (baby) Dairy Supplement (Lactaid) Bismuth Subsalicylate liquid (Pepto Bismol) Ibuprofen (Advil) Bismuth Subsalicylate tablets (Pepto Bismol) Ibuprofen Children’s tablets Calcium Carbonate (Children’s Pepto, Tums) Loperamide (Imodium) Calamine lotion

First Aid Supplies

Item Item Ace Bandages / Coban 2” x 5yards Gauze 2X2 Alcohol Isopropyl Gauze 4X4 Alcohol prep pads 100 Gauze Roll Aloe Gloves (L, XL) AED with Defibrillator pads Child/ Adult Hydrocortisone cream Antibacterial wipes Hydrogen Peroxide

Bacitracin Zinc Ointment Medical tape 1” and 3” Band-Aid’s Assorted Moleskin Band-Aid Wash Pulse oximeter Butterfly bandages Q-tips Cervical Collar adjustable (adult/child) Sterile water/irrigation Chapstick/ petroleum jelly SAM splints Cold Compress 4”x5” Thermometer with covers or alcohol pads Cotton Balls Tick removal kits w/ test kits CPR Face masks Tongue depressors Cravats Trauma sheers Eye wash Tweezers Face masks Witch Hazel Flashlight Ziploc bags (for meds and ice packs) 1 qt.

Finger splints

Personal Hygiene Items/Accessories

1” 3 ring binder w/ blank Treatment logs Feminine napkins/pads/tampons 1” 3 ring binder w/ blank Medication administration form blank Finger/toenail clippers Bug Spray Hand sanitizer Baby powder Index cards Baby wipes Toothbrushes Combs Toothpaste Deodorant Towels/wash clothes Disposable razors Soap Dixie cups (xs) Sunscreen Ear plugs

3.3 Equipment: AED, CPR Masks (Youth Program provided).

3.4 Services: Contractor and/or contractor personnel must hold liability insurance in accordance with 52.237-7 Indemnification and Medical Liability Insurance. The coverage shall be at least 1 million per claim and $3 million per annum.

3.5 Utilities: All utilities in the facility will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount. The facility will have potable running water and electricity available to contract employees.

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E): The contractor shall provide a stethoscope, blood pressure cuff, (child – adult), PPE and other personal, professional items as warranted by professional standards. The Government will not reimburse the contractor for these items and they shall remain the property of the contractor after the contract ends.

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

4.2 Reserved

4.3 Reserved

5.0 Requirements: The contractor shall:

5.1 Provide two (2) Level 2 Registered Nurses (RNs) to staff the medical room 24/7 from 8-21 July 2023. They must hold a valid Maine Registered Nurse license or a Compact Nurse license.

5.1.2 The Nurses shall record patient histories, perform various diagnostic tests, administer medications, and develop patient care plans in conjunction with other medical professionals. They will also provide professional nursing care to assigned patient(s).

5.1.3 Level 2 Registered Nurses shall have at least two years’ experience as active/practicing RNs with at least one year of pediatric, school, or camp nursing experience preferred.

5.1.4 Provide overall management of a medical room serving approximately 150-175 children and adults and have good communication skills with all involved.

5.1.5 Precise management of prescribed, OTC, and standing order medications.

5.1.6 Coordination and communication with guardians and camp staff.

5.1.7 Develop and implement nursing care plans while monitoring healthcare and maintaining health records.

5.1.8 Work with 1-2 health care assistants provided by MEARNG.

5.1.9 Provide daily reports to Camp Coordinators of injuries and health concerns of camp participants.

5.2 Service Contract Reporting:

5.2.1 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.

5.2.2 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 31st for services performed under this contract during the preceding Government fiscal year (October 1 – September 30).

https://sam.gov/

The DoD Guidebook for Service Contract Reporting in SAM is 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 and searching the “Help” section. The SAM Federal User Guide is also available in the “Help” section for comprehensive instructions on navigation SAM. Contractors requiring assistance using SAM should contact the Federal Service Desk at https://www.fsd.gov.

6.0 Applicable Publications: Publications applicable or mentioned in this PWS are listed below:

Publication (Chapter/Page)

Date of Publication

Website

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

Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/curr ent/index.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/do dm

Federal Information Processing Standards (FIPS) Publication

201-2 Personal Identity Verification (PIV) of Federal Employees and Contractors

(paragraph 9)

August http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIP S.201-2.pdf

DoDM 5200.2 Procedures for the DoD Personnel Security Program

(PSP)

04/03/2017 https://www.esd.whs.mil/Directives/issuances/d odm/

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/d odi/

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 odi/

DoD 5400.11-R

Department of Defense Privacy Program

05/14/2007 https://www.esd.whs.mil/Directives/issuances/d odm/ https://dodprocurementtoolbox.com/site-pages/service-contract-reporting-scr https://dodprocurementtoolbox.com/site-pages/service-contract-reporting-scr https://sam.gov/ https://www.fsd.gov/ https://www.acquisition.gov/?q=browsefar http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html 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://www.esd.whs.mil/Directives/issuances/dodm http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf 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/dodm/ https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.dhs.gov/homeland-security-presidential-directive-12 https://www.esd.whs.mil/Directives/issuances/dodi/ https://www.esd.whs.mil/Directives/issuances/dodi/

DoDD 8140.01 Cyberspace Workforce

Management

10/05/2020 odd/

DoD 8570.01-M

Information Assurance 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 Policy and Implementation

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

03/07/2014 https://armypubs.army.mil/ProductMaps/PubFo rm/ArmyDir.aspx

AR 25-2

Information Assurance

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

AR 530-1

Operations Security

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

AR 525-13

Antiterrorism

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

AR 381-12

Threat Awareness and Reporting

Program (TARP) (Section II, ¶ 2-4.b)

06/01/2016 http://armypubs.army.mil/ProductMaps/PubFor m/AR.aspx

AFI 10-245

Antiterrorism

03/28/2013 (Certified current

03/30/2017 https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&s eries=-1&modID=449&tabID=131

AFI 31-101

Security Forces Standards and

Procedures

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

AFMAN 31-113

Security Forces Standards and Procedures

03/05/2013 Change 1:

12/02/2015 https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&s eries=-1&modID=449&tabID=131

AFPD 17-1

Information Dominance Governance and Management

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

AFMAN 17-1301

Computer Security (COMPUSEC) 02/12/2020 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1&s eries=-1&modID=449&tabID=131

AFI 10-701

Operations Security

7/24/2019 (Change 1:

06/09/2020 https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&s eries=-1&modID=449&tabID=131 https://www.esd.whs.mil/Directives/issuances/dodd/ https://www.esd.whs.mil/Directives/issuances/dodd/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ https://www.esd.whs.mil/Directives/issuances/dodm/ 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://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

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).

PWS Paragraph Task Performance

Standard Acceptable

Quality Levels

(AQL)

Surveillance Method / By Whom

The contractor will provide two medical personnel (Registered Nurse) to oversee the medic room for a youth camp comprised of 100 children and 50 adults (each week) from July 8-21, 2023 (Para 5.0)

The contractor will provide two medical personnel (Registered Nurse) to oversee the medical room within the established timeframe.

The contractor will provide two medical personnel (Registered Nurse) to oversee the medical room 100% of the time within the established timeframe.

2% failure to provide two medical personnel (Registered Nurse) to oversee the medical room within the established timeframe.

Periodic Inspection

- POC will be on site and will monitor during the established timeframe.

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.1 Criminal History

Background Check

Information will be provided 14 Calendar days after award.

1 Electronic Submission

COR/KO

1.4.10 Contractor

Employees T-Shirt

Size

Information will be provided 14 Calendar days after award.

1 Electronic Submission

COR

PIEE-WAWF

Invoicing

Submission within 14 Calendar days of period of performance ended

1 Electronic Submission https://wawf.eb.mil/piee-landing/ https://wawf.eb.mil/piee-landing/ https://wawf.eb.mil/piee-landing/