PWS Q3Q4.pdf

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Attached to
PHA and Dental Services 3Q and 4Q Federal contract opportunity
Solicitation number
W911YN-20-Q-0010
Issued by
Department of the Army Florida Army National Guard

About this file

This is a performance work statement (PWS) for providing non-personal healthcare services to the Florida Army National Guard (FLARNG), including Soldier medical records updates at various locations across Florida from April to August 2020. Services required include conducting periodic health assessments, dental exams, x-rays, and potential follow-up dental treatment. The contractor must update medical and dental records in the appropriate databases and provide post-event reports summarizing all services for each individual Soldier. Pricing is required as separate line items for healthcare exams versus potential follow-on dental treatment at eight identified locations on different dates between April and August 2020. The last date for questions is March 12, 2020.

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Other files for this federal contract opportunity

Other files attached to PHA and Dental Services 3Q and 4Q, newest first.
File Type Posted
PHA and Dental Services 3Q4Q Question Set 1.pdf PDF
Technical Exhibit 3.3 _ 18-19 April 2020 Eustis.pdf PDF
Technical Exhibit 5_Requirements.pdf PDF
W911YN-20-Q-0010 Sol PHA_Den Q3Q4.pdf PDF
Wage Determination_Duval County (Jacksonville).pdf PDF
Wage Determination_Washington County (Chipley).pdf PDF
Technical Exhibit 3.5 _ 2-3 May 2020 Starke.pdf PDF
Technical Exhibit 3.4 _ 18-19 April 2020 Miramar.pdf PDF
Wage Determination_Escambia County (Pensacola).pdf PDF
Technical Exhibit 3.8 _ 1-2 August 2020 Jacksonville.pdf PDF
Technical Exhibit 3.6 _ 16 May 2020 Pensacola.pdf PDF
Technical Exhibit 3.7 _ 16-17 May 2020 Chipley.pdf PDF
Technical Exhibit 6_FLARNG_Account_Request_Guide20180329.pdf PDF
Wage Determination_Bradford County (Starke).pdf PDF
Wage Determination_Citrus County (Crystal River).pdf PDF
Technical Exhibit 4_DoD_PHA_Fact_Sheet.pdf PDF
Technical Exhibit 3.1 _ 4 April 2020 Crystal River.pdf PDF
Wage Determination_Lake County (Eustis).pdf PDF
Wage Determination_Palm Beach County (West Palm Beach).pdf PDF
Wage Determination_Broward County (Miramar).pdf PDF
Technical Exhibit 7_Sample_DD_2875_NETWORK.pdf PDF
Technical Exhibit 3.2 _ 4-5 April 2020 West Palm Beach.pdf PDF
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PERFORMANCE WORK STATEMENT (PWS)

FOR PROVIDING ANNUAL MEDICAL AND DENTAL SCREENINGS TO INCLUDE

DENTAL TREATMENT OF DENTAL CLASS III CONDITIONS

PART 1

GENERAL INFORMATION

1. General: This is a non-personal services contract to complete annual and deployment medical requirements. 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 annual medical and dental readiness services, as defined in this PWS.

1.1 Scope: The main objective of this contract is to conduct and complete annual medical requirements for FLARNG Service Members in accordance with Army Regulations 40-501, 502, 40-3, DoDI

1.2 Background: Individual Medical Readiness (IMR) and Fully Medically Ready (FMR) Service Members are the foundation of force-sustainment for Army National Guard (ARNG) forces. Medical and Dental health is vital for force health protection, and failure to achieve a standard of level of medical and dental health could preclude a Soldier from deploying. Medical and Dental Readiness is a command responsibility. The purpose of this PWS is to cover the various components of IMR/FMR, to include, but not be limited to: Medical: Blood Pressure, height & weight, and questionnaire screening, Periodic Health Assessments (PHAs); Specialty Physical Exams such as Chapter 2 (schools), 'Over-40,' Flight, etc., in accordance with AR (Army Regulations) 40-501 (Standards of Medical Fitness), AR 40-502 Medical Readiness, and Department of the Army Pamphlet 40-502; laboratory / phlebotomy work such as specimen collection for HIV testing, urine pregnancy testing, pap-smear evaluation, DNA testing, and G6PD and RPR testing; Immunizations required for IMR/FMR and theater specific compliance such as Hepatitis A/B, Influenza, PPD (in some cases, vaccines will be supplied by ARNG), visual acuity and Optometry exams, mobile facility audiometry exams, comprehensive audio evaluations, and SPRINT testing, MODS/MEDPROS entry of all applicable and appropriate IMR/FMR functions including completion of the electronic DoD-PHA in the MODS online module during an event by providers trained in completing the DoD-PHA online, and Post Deployment Health Reassessments (PDHRA). Dental: annual dental exams, digital bitewings radiographs, digital panoramic radiographs, DENCLASS data entry of all radiographs and dental records, identification and treatment of all Class 3 Soldiers who are eligible to be treated in a remote treatment setting and are not projected to require follow up dental treatment procedures.

1.3 Period of Performance (PoP): The PoP for this contract shall be 5 months.

1.4 General Information

1.4.1 Quality Control: The contractor shall develop and maintain an effective Quality Control 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.

1.4.1.1 The Contracting Officer may notify the Contractor of required modifications to the plan during the period of performance. The Contractor then shall coordinate suggested modifications and obtain acceptance of the plan by the Contracting Officer. Any modifications to the program during the period of performance shall be provided to the Contracting Officer for review no later than 10 working days prior to effective date of the change. The QCP shall be subject to the Governments review and approval. The Government may find the QCP "unacceptable” whenever the Contractors procedures do not accomplish quality control objective(s). The Contractor shall revise the QCP within 10 working days from receipt of notice that QCP is found "unacceptable."

1.4.2 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).

1.4.3 Recognized Holidays: The following are recognized US holidays.

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

1.4.4 Place of Performance: The contractor shall provide pre-event coordination of requirements with government personnel between the hours of 0900-1700EST Monday thru Friday, except on recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Performance of services shall be as outlined in each Technical Exhibit 3 per event. The work to be performed under this contract shall be performed at government facilities throughout the state of FL. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential.

1.4.4.1 Telework: Telework is in the best interest of the government for meeting deliverables of this contract outside of providing the performance of services as outlined in each events Technical Exhibit 3. Telework shall be at no additional cost to the Government.

1.4.4.2 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.4.3 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. All contractor employees shall carry proper identification with them at all times, and shall be subject to such checks as may be deemed necessary. 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 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.

1.4.5 Security Requirements: The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DoD), Headquarters Department of Army (HQDA) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.5.1 For contractors requiring Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential. CAC issuance requirements are as follows:

In accordance with Department of Defense Manual (DoDM) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. The issuance of a CAC will be based on four criteria: (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 3, 2017, and (d) verification of a claimed identity. Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID

System (RAPIDS) using the DD Form 1172-2, or the Trusted Associate Sponsorship System

(TASS).

1.4.5.1.1 HSPD-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them, and shall process all CAC card applications. The contractor shall ensure that all employees requiring an initial background investigation complete a Personnel Security Investigation Portal (PSIP) form at Attachment (state attachment number if known, otherwise, state “TBD”), at the earliest possible date and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward it to the National Guard Bureau (NGB) Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm that the investigative service provider has received the request, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e-QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the background investigation (BI) will be initiated. The contractor shall ensure immediate compliance with all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from two to six weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that contractor employees meet CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.

1.4.5.1.2 Trusted Associate Sponsorship System (TASS): The contractor shall process CAC applications through the TASS, the procedures for which are described below. Although there is no requirement for the contractor to designate a “Corporate Facility Security Officer" (FSO) to serve as its single point of contact for the BI, the TASS application process and other CAC and security-related matters, such designation facilitates these processes. If an FSO is not established, all contractor employees requiring a CAC will be required to process their own applications. The submission process for CAC applications is as follows:

1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA). The TASS TA for this requirement will be: (If the TA has been designated, show the TA’s name and contact information; otherwise, insert “TBD.”)

2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at: https://www.dmdc.osd.mil/tass/. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.

3. The Government will inform the contractor's applicant, via email, of one of the following:

a. Approval.* Upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a RAPIDS station (RAPIDS Site Locator:

http://www.dmdc.osd.mil/rsl/).

b. Rejection.* The Government, in separate correspondence, will provide reason(s) for rejection.

c. Return. Additional information or correction to the application required by the contractor employee.

*The contractor shall maintain records of all approved and rejected applications.

1.4.5.1.3 At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification. Identity source documents must come from the list of acceptable documents included in Form I-9, OMB No. 1615-0047, "Employment Eligibility Verification." Consistent with applicable law, at least one document from the Form I- 9 list shall be a valid (unexpired) State or Federal Government-issued picture ID. The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS, and will then issue a CAC. Issued CACs will be valid for no longer than three years, or until the individual's contract end date (inclusive of any options), whichever is earlier.

1.4.5.1.4 The contractor shall return issued CACs to the DEERS office upon departure or dismissal of each contractor employee, and shall obtain a receipt for each card and provide it to the TA/COR.

1.4.5.1.5 The contractor shall manage requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The contractor shall provide at least 10 calendar days advance notice to the TA, unless there are extenuating circumstances approved by the COR or KO.

1.4.5.1.6 The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a government computer network. This can be done by going to: http://www.us.army.mil and registering as an "Army Guest," with the sponsor being the COR or a COR- designated individual if the COR is ineligible to Serve as an AKO Sponsor. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.

1.4.5.2 For contractors that do not require a CAC, but require access to a DoD facility or installation: Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-

05/AR 190-13), and applicable installation, facility and area commander installation/facility access, and local security policies and procedures (provided by a government representative).

1.4.5.3 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.

1.4.5.4 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the Army Enterprise Info structure (AEI). Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall:

1.4.5.4.1 Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.

1.4.5.4.2 Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training https://informationassurance.us.army.mil).

1.4.5.4.3 Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.

1.4.5.4.4 Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.

1.4.5.4.5 Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.

1.4.5.5 Protection of Personally Identifiable Information (PII)/Protected Health Information (PHI)/ HIPAA. 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; PHI encountered IAW 45 CFR 160.130, Section 13400 of HITECH Act; and HIPAA encountered IAW 45 CFR 160 and 164. If a PII/PHI/HIPAA 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/PHI/HIPAA has been compromised. Complete

HIPAA training at http://www.health.mil/Training-Center/Joint-Knowledge-Online-JKO (https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf).

1.4.5.6 AT Level 1 Awareness Training (AT): All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete Level 1 AT within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor 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 AT is available at http://jko.jten.mil/courses/atl1/launch.html.

1.4.5.7 Information Assurance (IA)/Information Technology (IT) Training: All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.

1.4.5.8 Information Awareness: All contractor employees with access to a government information system shall be registered in the Army Training Certification Tracking System (ATCTS) (https://atc.us.army.mil/iastar/index.php) at commencement of services, and shall successfully complete the DoD Information Assurance awareness training prior to access to the IS and then annually thereafter. (https://cs.signal.army.mil).

1.4.5.9 iWATCH Training: NA

1.4.5.10 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of contract award and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training or prior to attending an event whichever comes first. Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.

1.4.5.11 Reserved.

1.4.5.12 Classified Information. This contract is not projected to require a clearance beyond a NACI. If a need to access classified information is identified a 30 day notice will be provided via the KO in order for the contractor to add handling of classified information to their QCP.

The contractor shall comply with Federal Acquisition Regulation (FAR) Clause 52.204-2, Security Requirements. This clause applies to contracts that involve access to information classified “Confidential,” “Secret,” or “Top Secret,” and requires contractors to comply with the

Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (DoD 5220.22-M) and applicable updates/changes.

1.4.5.13 Threat Awareness and Reporting Program (TARP). Per AR 381-12, Threat Awareness and Reporting Program (TARP), contractor employees must receive annual TARP training by a counterintelligence (CI) agent or other trainer as specified in Chapter 2 Threat Awareness and Education, Section II, paragraph 2-4b. The contractor shall identify annual TARP training, personnel trained and date of training with the Monthly Progress Report.

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. NOTE: All references to keys include key cards. The contractor shall establish and implement methods of ensuring that no keys/key cards issued by the Government are lost or misplaced or are used by unauthorized persons. No keys issued by the Government shall be duplicated. The contractor shall include procedures covering key control in the QCP.

Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the COR.

1.4.6.1.1 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.

1.4.6.1.2 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 skills applicable to performance of this contract. This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information.) HIPAA Training, access to DOEHRS and applicable modules in MODS and MEDCHART databases. (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 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 Subpart 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.

1.4.8.1 Contractors shall review services required per event by SM and be prepared to discuss services required during pre-event meetings/conference calls to ensure all resources are synchronized to convert SMs attending events to a MRC 1 or 2.

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. 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 vehicles passes) to the COR within 14 days of an employee’s departure.

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.

1.4.12 Reserved

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.

1.5 Key Personnel: Personnel providing deliverables for this contract shall be experienced and qualified in all aspects of their respective functional areas. Contactor personnel shall not perform inherently governmental functions (i.e., representation of government, decision authority, etc.).

The follow personnel are considered key personnel by the Government:

1.5.1 Contract Manager: The Contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the Contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between the dates/times specified in Technical Exhibit 3.

1.5.2 Physician (General and Family Practice): years of experience in specialty: minimum 1 year practice experience, minimum education: Possess MD or DO from accredited school, certification/license: active unrestricted state medical license, ACLS: preferred, and BCLS:

preferred

1.5.3 Optometrist: years of experience in specialty: minimum 1 year practice experience, minimum education: Possess OD from accredited school, certification/license:

active/unrestricted state licensure required, ACLS: preferred, and BCLS: preferred.

1.5.4 Audiologist: years of experience in specialty: minimum 1 year practice experience, minimum education: possess MA or AuD from accredited school certification/license:

active/unrestricted state licensure required, ACLS: preferred, and BCLS: preferred.

1.5.5 Physician’s Assistant: Years of Experience in Specialty: minimum 1 year experience, minimum education: master’s level degree and accredited PA program, certification/license:

licensure required for state employment, BCLS: preferred

1.5.6 Behavioral Health Counselor: years of experience in specialty: minimum 1 year experience, minimum education: master’s level degree, certification/license: licensure required for state employment, BCLS: preferred

1.5.7 Nurse Practitioner: Years of Experience in Specialty: minimum 1 year experience, minimum education: MSN or Advanced Certification, certification/license: required for state employment, ACLS: preferred, BCLS: required for state employment.

1.5.8 Registered Nurse: general years of experience in specialty: minimum 1 year experience, minimum education: RN-AD or diploma, BSN preferred, certification/license: certification preferred, licensed required for state employment, ACLS: preferred, BCLS: required for state employment.

1.5.9 Medical Assistant (Certified/Registered): years of experience in specialty: minimum 1 year experience, minimum education: state license and graduate of accredited MA program, certification/license: required

1.5.10 Hearing Technician: years of experience in specialty: minimum 1 year experience, minimum education: Council for Accreditation in Occupational Hearing Conservation (CAOHC) certified: required

1.5.11 Optometry Technician: 2 years of experience in specialty: NA, minimum education: High School Diploma

PART 2

DEFINITIONS & ACRONYMS

2. 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. CONTRACTING OFFICER (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the Government. Note: The only individual who can legally bind the Government.

2.1.3. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S.

Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.5. DELIVERABLE. Anything that can be physically delivered and include non-manufactured things such as meeting minutes or reports.

2.1.6. 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 Key Personnel listed in 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.

2.1.7. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.8. QUALITY ASSURANCE. The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.9. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of Contractor performance.

2.1.10. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.11. SUBCONTRACTOR. One that enters into a contract with a prime Contractor. The Government does not have privity of contract with the subcontractor.

2.1.12. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.2. ACRONYMS:

AEI Army Enterprise Infostructure ADCS Army Dental Care System

ADA American Dental Association ADDR Active Duty Dental Repository ALARACTS All Army Activities ACOR Alternate Contracting Officer's Representative AFARS Army Federal Acquisition Regulation Supplement AKO Army Knowledge Online AMEDD Army Medical Department AR Army Regulation ARNG Army National Guard ATCTS Army Training Certificate Tracking System AT/OPSEC Antiterrorism/Operational Security AUP Acceptable Use Policy BBP Best Business Practices BH Behavioral Healthcare BHDP Behavioral Health Data Portal BI Background Investigation CAC Common Access Card CCE Contracting Center of Excellence CFP/M/E Contractor Furnished Property, Materials, and Equipment CFR Code of Federal Regulations CLIA Clinical Laboratory Improvement Amendments CM Contract Manager COMSEC Communications Security CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf DA Department of the Army DD250 Department of Defense Form 250 (Receiving Report) DD254 Department of Defense Contract Security Requirement List DENCLASS Dental Classification Application DENCOM Dental Command DFARS Defense Federal Acquisition Regulation Supplement DMDC Defense Manpower Data Center DNA Deoxyribonucleic Acid DOD Department of Defense DODAAC Department of Defense Activity Address Code DODI Department of Defense Instruction DODM Department of Defense Manual DOEHRS Defense Occupations and Environmental Health Readiness System DRC Dental Readiness Classification DTR Dental Treatment Record eCASE Electronic Case Management EHR Electronic Health Record ePROFILE Electronic Profile System eQIP Electronic Questionnaires for Investigations Processing

FAR Federal Acquisition Regulation FLARNG Florida Army National Guard FMR Fully Medically Ready FOUO For Official Use Only FPCON Force Protection Condition GFP/M/E/S Government Furnished Property/Material/Equipment/Services G6PD Glucose - 6 - Phosphate Dehydrogenate HCG Human Chorionic Gonadotropin HIPAA Health Insurance Portability and Accountability Act of 1996 HIV Human Immunodeficiency Virus HQDA Headquarters Department of Army IA Information Assurance IAW In Accordance With IMR Individual Medical Readiness IS Information System(s) ISO Isolation IT Information Technology KO Contracting Officer MEB Medical Evaluation Board MEDCOM U.S. Army Medical Command MEDCHART Medical Electronic Data (for) Care History and Readiness Tracking MEDPROS Medical Protection System MMRB Medical MOS Retention Board MND Medical Non-deployment Module MWDE MEDPROS Wed Data Entry MODS Medical Operational Data System MOS Military Occupational Specialty MRC Medical Readiness Classification NGB National Guard Bureau OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs OPSEC Operations Security OSArS Office of the State Army Surgeon OSHA Occupational Safety and Health Administration PDHRA Post Deployment Health Reassessment PEB Physical Evaluation Board PHA Periodic Health Assessment PHI Protected Health Information PII Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact PPD Tuberculosis/Tuberculin Skin Test PPE Personal Protective Equipment PRS Performance Requirements Summary PSIP Personnel Security Investigation Portal

PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program RAPIDS Real-Time Automated Personnel ID System RDA Registered Dental Assistant RPR Rapid Plasma Reagin SM Service Member SPRINT Speech in Noise Recognition Test SRC Soldier Readiness Check SRP Soldier Readiness Processing STR Soldier Treatment Record SOW Statement of Work TA Trusted Agent TASS Trusted Associate Sponsorship System TE Technical Exhibit TITMUS Vision Testing Equipment Manufacturer’s Name TMC Troop Medical Clinic

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: The Government will provide a pre-event point of contact to coordinate services, an on-site POC to coordinate entry to the facility and assist with providing access to government, provided tables, chairs, spaces to be used when applicable, and .mil domain access (when applicable).

3.2. Facilities: The Government will provide adequate work space for the contactor to complete all requirements in the time designated. A government representative will be designated to provide the contractor access and to secure the facility at the conclusion of each day.

3.3. Utilities: Unless mobile facilities are required, the Government will make available all utilities in the facility for the Contractor’s use in performance of tasks outlined in this PWS. IT network access will only be provided when required databases for completion of services are on a .mil domain. If utilities are furnished, the following is required, the Contractor shall instruct employees in utilities conservation practices. The Contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning vehicles and equipment.

3.4. Equipment: The Government will not provide equipment unless .mil domain access is required. When .mil domain access is required the government will provide computers to designated contracted personnel after the FLARNG network access requirements are complete 14 days or 10 working days prior to the first date the .mil domain needs to be accessed.

3.5. Materials: The government shall supply:

3.5.1 Routine adult immunizations, HIV testing packaging, and shipping materials

3.5.2 DNA supplies, shipping supplies, and shipping guidance

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

4.2. Materials. The Contractor shall furnish medical and dental service materials and supplies necessary to meet the requirements under this PWS.

4.3. Equipment .The Contractor shall furnish medical and dental equipment to provide the services to meet the requirements under this PWS. Contractor will also provide computer kiosks with CAC card readers and internet access for Soldiers to complete DoD-PHA screening through MODS. The Contractor shall identify the number of computers needed to provide deliverables if MODS is on a .mil domain. Government information system network access procedures not outlined in this PWS, will be provide upon award. The contractor shall supply their own computer access for military medical database input to all applicable databases, not on a .mil domain.

4.4 Facilities. The contractor shall conduct dental treatment in a mobile dental practice with dental suction equipment installed. The contractor shall conduct hearing screenings in a sound proof mobile hearing practice. When Exhibit 3 indicates additional mobile facilities are required, for the contractor to provide services the contractor shall provide OSHA-Compliant Mobile Health Practices. Compliance with OSHA, State, & Federal Regulations is mandatory.

4.5 Utilities. Contractor shall provide utilities for all mobile facilities providing services as required in this contract.

PART 5

SPECIFIC TASKS & REQUIREMENTS

5. SPECIFIC TASKS & REQUIREMENTS: Section 5 describes each service in detail.

Services required per event and event locations will be indicated on Technical Exhibit 3 per event.

5.1 DoD Periodic Health Assessments (DoD-PHA): The contractor shall conduct DoD-PHAs in accordance with the DoD-PHA guidance set forth by AR 40-50, DA PAM 40-502, and the DoD- PHA Fact Sheet. Contractors shall have the capability to provide all annual screening services to complete the DoD-PHA and complete the DoD-PHA on site in the applicable MODs module.

Any counseling conducted during the DoD-PHA provider interview will be documented in the electronic DoD-PHA survey and on Government provided forms, such as a SF 600.

5.2 Post Deployment Health Re-Assessments (PDHRA): the contractor shall conduct PDHRAs in accordance with DoDI 6490.03. The contractor shall complete a PDHRA in conjunction with a DoD-PHA when required.

5.3 Physical Exams: the contractor shall have the capability to conduct other physical exams in accordance with AR 40-502.

5.4 Vision Services

5.4.1 Visual Acuity Testing (Snellan/near vision): The contractor shall conduct visual acuity testing in accordance with AR 40-501, DA PAM 40-502, and DA PAM 40-506.

5.4.2 Eyewear Prescriptions: The contractor shall provide DD Form 771s with bridge and frame size in accordance with DA PAM 40-502.

5.5 Hearing Exams. The contractor shall conduct audiometry in accordance with AR 40-501, AR 40-502, and DA PAM 502. Hearing exams will be conducted using the DOEHRS-HC compatible audiometers (Benson) with DOEHRS software. Adherence to all requirements of OSHA, State & Federal Regulations is mandatory. Audiology evaluations and Speech Recognition in Noise Test (SPRINT) testing will be performed IAW all applicable Federal, DOD, MEDCOM, NGB, and State guidelines. The contractor shall complete all hearing exams with a DOEHRS Compatible Audiometer Testing with capability to upload results into ANCI certified and DOEHRS compatible audiometer computer. Hearing Conservation and Hearing Readiness tests shall be completed in a sound booth. The noise levels within the hearing test environment shall not exceed those shown in DA PAM 40-501, Table 7-1. Stationary audiometric test booths shall be evaluated on an annual basis using sound level meter equipment conforming to: a. At least the Type 1 requirements of the ANSI Standard S1.4-1983 (R 1997) and S1.4A-1985 Amendment (or latest approved standard).b. The band filter sets shall conform to requirements for Order 3, Type 3-D, extended range as specified by the latest ANSI Standard S1.11. Soldiers will be tested in a sound booth that meets the American National Standards Institute (ANSI) Maximum Permissible Ambient Noise Levels (MPANL) S3.1, 1999 (R 2008) as measured using a Type 1 Sound Level Meter (SLM) IAW DA Pam 40-501 and will ensure that the USAPHC Audiometric Test Booth Certification Form is posted on the audiometric test booth(s). Noise level measurements must be recorded on the U.S. Army Public Health Command Audiometric Test Booth Certification Form with a copy furnished to the Hearing Program

Manager or their representative. The USAPHC Audiometric Test Booth Certification Form is available at:

http://phc.amedd.army.mil/PHC%20Resource%20Library/AudiometricTestBoothCertification.p

df. Noise level measurements for mobile audiometric test booths shall be evaluated each time they are moved to a new location or at a minimum, annually, if they are never moved and are used as stationary audiometric test booths. Ventilation systems in audiometric test booths shall provide adequate air exchange for patient comfort and acceptable sound levels for valid audiometric testing.

5.5.1 Comprehensive Audio Evaluation (CAE) Testing for ARNG, the Contractor shall perform CAE testing and diagnostic audio testing, including Pure Tone Air and Pure Tone Bone Tests, and SPRINT testing as indicated by initial screening results and after appropriate unit authorization is obtained. These CAE services may include emittance testing, tympanometry, acoustic reflex, speech reception thresholds, word recognition testing, and otoacoustic emissions.

The Contractor shall upload all pure tone audio test results into the DOEHRS-HC database within three (3) working days of completion and shall verify upload.

5.5.2 SPRINT testing shall be available at all events when requested and the results shall be available immediately. The contractor shall check that member has DD Form 2215 (baseline Audiogram) recorded in the medical information system (DOERS-HC) and medical record; and if no DD Form 2215 is in the medical record, perform DOEHRS-HC approved audiograms, and all service members with a DD Form 2215 on file have a DD Form 2216 completed. Contractor shall provide a list of personnel who require audiograms.

5.6 Immunizations: The contractor shall conduct immunizations in accordance with AR 40-562, DA PAM 40-502, AR 40-502. Immunizations shall include routine adult profile and deployment immunizations.

5.6.1 The contractor shall provide and follow a vaccine handling plan.

5.6.2 Typical vaccines include…

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