PHA_combined_synopsis_solicitation_PD2.docx

W91242-17-R-0001

COMBINED SYNOPSIS/SOLICITATION W91242-17-R-0002

ISSUED DECEMBER 13, 2016

Part: U.S. Government Procurements Subpart: Services Class Code: 25.6 Medical Care

Address of Contracting Office: USPFO for North Carolina, 4201 Reedy Creek Rd., Raleigh, NC 27607, United States of America

Subject: Medical and Dental Services

Solicitation Number: W91242-17-R-0001

Reponses Due: December 28, 2016 at 1:00 P.M local time (Raleigh, NC)

Anticipated award date is Jan 2, 2017.

Points of Contact: Heather Bushouse, e-mail: heather.m.bushouse.civ@mail.mil, phone: 919-664-6021 or CPT Rodney Daniels, email: Rodney.l.daniels.mil@mail.mil, phone: 919-664-6474

Contracting Officer Point of Contact: MAJ Derek Meilinger, e-mail: derek.t.meilinger.mil@mail.mil Phone: 919-664-6019

Web Address: http://nc.ng.mil/uspfo/

Description of Requirement: This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6 and 13.5, as supplemented by additional information included in this notice. This acquisition is a 100% set aside for small business. This announcement constitutes the only solicitation and additional information will not be provided. Proposals are requested under Request for Proposals (RFP) W91242-17-R-0002 for services listed on pages 3-5.

The performance period is from date of award through 31 March 2017. Delivery is FOB Destination.

The Government intends to award a contract resulting from this solicitation to the lowest-priced, technically acceptable offer with acceptable past performance. The USPFO of NC, Acquisition Support Division (USPFO-NC-ASD), reserves the right to conduct discussions prior to award. Any deviation from the terms, conditions, or requirements of this solicitation may result in offers being determined ineligible for award. Potential offerors are encouraged to submit any questions regarding this solicitation to the USPFO-NC-ASD Points of Contact provided herein prior to the offer due date and time.

This RFP incorporates provisions and clauses in effect through Federal Acquisition Circular 2005-83.

FAR provision 52.212-3 Offeror Representations and Certifications-Commercial Items applies to this acquisition. Offerors shall complete this provision in the System for Award Management (SAM). SAM is an official U.S. Government system and all offerors are required to be registered in this system. There is NO fee to register for this site. Please provide your CAGE Code from SAM with your offer.

The Government contemplates award(s) of a Firm Fixed Price contract resulting from this combined synopsis/solicitation for performance of medical and dental services in North Carolina.

Proposals must be received no later than 1:00 PM local time (Raleigh, NC) on December 28, 2016. Offers shall be submitted via email to heather.m.bushouse.civ@mail.mil. When submitting offers, please note the RFP number W91242-17-R-0001 in the subject line of the email. A confirmation of receipt will be sent to your once your offer has been received. Please note that the offeror assumes all risk for any delay in the transmission of their proposals. Any offers received after the above deadline will not be considered. All offerors are encouraged to review FAR 52.212-1 INSTRUCTIONS TO OFFERORS. All offerors are further encouraged to submit their proposals early.

Medical & Dental PHA, Durham, NC

FFP

2-Day Event: 21- 22 January 2017 Unit: HHC, C, D, 236th BEB, E Co 230th BSB Annual Medical Readiness Event. PAX: 300, Address: 801 Stadium Drive, Durham, NC 27704 FOB: Destination

NET AMT

Medical & Dental PHA, Hamlet, NC

1-Day Event: 21 January 2017 (Annual Medical Readiness Event), PAX: 230, Address: 219 Boyd Lake Rd, Hamlet, NC 28345. FOB: Destination

NET AMT

Medical & Dental PHA, Roanoke Rapids, NC

1-Day Event: 11 February 2017, Unit: 20th SF Group (Dental and Hearing Event Only) , PAX: 88, Address: 813 E 14th Street, Roanoke Rapids, NC 27872.

FOB: Destination

NET AMT

Medical & Dental PHA, Lenoir, NC

2-Day Event: 11-12 February 2017, Units: 626 Maint Co / HHC 630th CSSB / 1450 Trans. (Annual Medical Readiness Event), 440 PAX, Address: 1535 Beecher Anderson Rd., Lenoir, NC 28645.

NET AMT

Medical & Dental PHA, Fort Bragg, NC

2-Day Event: 11-12 Feb 2017, Units: TBD (Annual Medical Readiness Event), Est. 250 PAX, Address: 3555 Owen Drive Fayetteville NC 28306

NET AMT

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

DELIVERY INFORMATION

22-JAN-2017

JFHQ - NORTH CAROLINA

1636 GOLD STAR DRIVE

RALEIGH NC 27607-6410

W802JL

21-JAN-2017

JFHQ NORTH CAROLINA

1636 GOLD STAR DRIVE

RALEIGH NC 27607-6410

W802JL

11-FEB-2017

JFHQ NORTH CAROLINA

1636 GOLD STAR DRIVE

RALEIGH NC 27607-6410

W802JL

12-FEB-2017

JFHQ - NORTH CAROLINA

1636 GOLD STAR DRIVE

RALEIGH NC 27607-6410

FOB: Destination

W802JL

05-MAR-2017

JFHQ - NORTH CAROLINA

1636 GOLD STAR DRIVE

RALEIGH NC 27607-6410

W802JL

SECTION C

Performance Work Statement for Contract Periodic Health Assessment (PHA) and Ancillary Laboratory, Audiology and Medical Support Services

PART 1

GENERAL INFORMATION

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, tools, materials, supervision, and other items and non-personal services necessary to perform medical service support as defined in this Performance Work Statement except as Specified in section 3.

1.2 Background: Individual Medial Readiness (IMR) and Fully Medically Ready (FMR) are the basic principles of force-sustainment for North Carolina Army National Guard (NCARNG) forces. Medical readiness is vital for combined force health protection and failure to achieve a standard of level of medical health could preclude a soldier from deploying. Medical Readiness is a command responsibility.

1.3 Objectives: The objective of this PWS is to conduct and complete, either selective services or as a complete service, the requirements of NCARNG IMR/FMR - Medical Readiness on all eligible (mobilizing or not) Service Members (SMs) in the NCARNG utilizing a HIPPA, Privacy Act, and OSHA-Compliant portable health facility.

· Medical evaluation by a licensed provider (Physician, Physicians Assistant (PA), or Nurse Practitioner (ARNP) IAW prescribed Army and NGB policy for Periodic Health Assessment, Physical Exams (Over-40, flight, and Specialty schools).

· All routine and ordered phlebotomy services provided on location or shipped to the required processing center(CDD for HIV).

· Electrocardiogram (EKG) service performed on all Soldiers over 40 years of age provided on location IAW CVSP guidelines.

· All routine and theatre specific immunizations provided by contractor, administered and annotated on a DD Form 2766 - Adult Preventive and Chronic Care Flowsheet provided on location.

· All baseline audiology (DD Form 2215 DD or DD Form 2216 Hearing Conservation Form), to include required follow-up for SPRINT Testing provided on location (if Audiologist is requested).

· Height, weight and blood pressure taken, recorded and stored electronically provided on location.

· Vision screening provided on location.

· Eye exams provided on location for all Soldiers scoring worse than 20/40 on vision screening (if Optometry is requested).

· Routine urinalysis for pregnancy testing and >40 years of age services (and specialty schools) provided on location.

· DNA and ABO-Rh testing/collection provided on location.

· Exams will be entered into the PHA module of MODS on location and required documentation loaded into HRR as required.

· Results entry and input/entry of all medical related FMR/IMR functions into the MEDPROS module of MODS provided/entered on location.

· Annotation and entry of services into the DD Form 2766 – Adult Preventive and Chronic Care Flow sheet or appropriate document.

1.4 General Information

1.4.1 Quality Control: The contractor shall develop and maintain an effective quality control program 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 quality control program is the means by which he assures himself that his work complies with the requirement of the contract. As a minimum, the contractor shall develop quality control procedures that address the areas identified in Technical Exhibit 1, “Performance Requirements Summary”. After acceptance of the quality control plan the contractor shall receive the contracting officer’s acceptance in writing of any proposed change to his QC system.

1.4.2 Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must 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 the minimum acceptable defect rate(s).

1.4.3 Government Remedies: The contracting officer shall follow FAR 52.212-4, “Contract Terms and Conditions-Commercial Items” or 52.246-4, “Inspection of Services-Fixed Price” for contractor’s failure to perform satisfactory services or failure to correct non-conforming services.

1.4.4 Recognized Holidays: The contractor is not required to perform services on these days Holidays or if the facilities are closed.

1.4.5 Hours of Operation/Place of Performance: The contractor is responsible for conducting the tasks listed in section 5.0 during drill weekends and/or as requested. Soldier Readiness Processing for deployment and other training periods that would require physician support during normal hours of operations to be estimated at 10 hours a day. Usual hours are between 0700 and 1900 unless special arrangements are made. Services are to be completed on site at various NC-ARNG Armories & Training Sites across the State. See established Clins for exact location and dates.

1.4.6 Travel Requirements: Contractor travel will be the sole responsibility of the contractor and should be included in the price schedule provided for services.

1.4.7 Qualifications: Providers holding a license to practice medicine. A provider is defined as: Advanced Registered Nurse Practitioner (ARNP), Physician’s Assistant (PA) or Physician (MD, DO). Medical services shall be performed by licensed medical professionals, who are board certified in their respective fields and have a license to practice medicine. Ancillary services (lab, vision, etc) will be provided by credentialed contractors but will work under the auspices of the licensed provider at [that] particular location. Contractor shall be held liable and is responsible for ensuring and verifying the appropriate level of Credentialing / Privileging (Licensure, Diploma, background checks, etc.) for all contact providers in support of any NCARNG event.

1.4.8 Special Requirements:

· OSHA & HIPAA-Compliant

· Full PHA &/or Physical Exam Requirements

· Real-time Data Processing & Uploading capability.

Additional MODS Medical Resources required:

· MEDPROS Wed Data Entry (MWDE) access/entry

· Electronic PHA Upload

· Entry of all work performed in the HRR module

· Entry of profiles into the e-Profile module

Contractor shall have network of local pharmacies for prescription medication services available for service members during contracted events.

1.4.9 Contracting Officer Representative (COR): The (COR) is identified below:

Primary: MAJ Brian E. Savage, North Carolina Army National Guard Deputy State Surgeon, G1- JFHQ, 919-664-6222 email brian.e.savage.mil@mail.mil Alternate: 2LT Jacquelyn Kahn, North Carolina Army National Guard HSS, G1-JFHQ, 919-664-6000 ext 46804

The COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.4.10 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.

1.4.11 Identification of Contractor Employees: All contract 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 in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

1.5 Security Training Requirements:

1.5.1 Base security will require all employees and affiliated personnel of the contractor to carry a State recognized identification card or drivers license and all vehicles are subject to search without reason. The contractor shall comply with all installation security requirements.

1.5.2 AT Level 1 Training: All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training. The contractor shall obtain and have on file all certificates of completion for each affected contractor employee and subcontractor employee and must be able to provide copies whenever required to the COR or to the contracting officer. AT level I awareness training is available at the following website: https://atlevel1.dtic.mil/at.

1.5.3 Access and General Protection/Security Policy and Procedures. This standard language text is for contractor employees with an area of performance within an Army controlled installation, facility or area. Contractor and all associated sub-contractors employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also 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. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

1.5.4 iWATCH Training. This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR.

1.5.5 Contractor Employees Who Require Access to Government Information Systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

1.5.6 For Contracts that Require OPSEC Training. Per AR 530-1, Operations Security, new contractor employees must complete Level I OPSEC training and must complete annual OPSEC awareness training.

1.5.7 For Information assurance (IA)/information technology (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of employment.

1.5.8 For information assurance (IA)/information technology (IT) cortication. Per DoD 8570.01-M , DFARS 252.239.7001 and AR 25-2, the contractor employees supporting IA/IT functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M must be completed upon contract award.

PART 2

DEFINITIONS & ACRONYMS

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

No armory, TMC, or office space will be provided or utilized unless prior approval is obtained from the Office of the State Army Surgeon. The Deputy State Surgeon of the NCARNG has the option to provide any and all management, labor, material, equipment, and supplies necessary for the contract medical provider to function operationally. It is expected that any contracted assets will integrate and work seamlessly with the contracted work staff. The services that the Deputy State Surgeon shall provide for the contract provider will meet readiness and deployability standards to ensure mission capability of the NCARNG. A Common Access Card (CAC) sponsored by the G1/Deputy State Surgeon shall also be provided.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4.1 General: Except for those items specifically stated to be government furnished in Part 3, the contractor shall furnish everything required to perform this PWS.

PART 5

SPECIFIC TASKS

5.1 Periodic Health Assessments (PHA): The contractor shall conduct PHAs in accordance with the PHA interim guidance set forth by the National Guard Bureau of the Surgeon General.

5.2 Periodic Health Assessments and Physical Exams: the contractor shall conduct Periodic Health Assessments (PHA) and other physical exams (Over-40, Chapter 2, Flight, etc.) in accordance with the AR 40-501 and the CVSP guidelines.

5.3 Visual Acuity Testing: The contractor shall conduct visual acuity testing in accordance with AR 40-501

5.4 Onsite at Post-Event Case Management of Temporary and Permanent Profiles:

· Licensed provider will identify and initiate the required Temporary and Permanent Profiles (T2 and T3, P2 and P3) to NCARNG soldiers via hardcopy record/spreadsheet, as well as, the MND module of MODS. A copy of the spreadsheet will be provided to the NCARNG case management staff at the event.

· The only permanent profiles to be written are for hearing (after SPRINT evaluation) or digital entry of a previously handwritten copy of a permanent profile.

· When required, contract manager will coordinate with Deputy State Surgeon and Health Services Section and arrange for fulfillment of required consultations and follow up.

· Follow-up conversations between Contractor and NCARNG treated soldier & Supervisor may be necessary depending on complexity of treatment and potential additional requirements.

5.5 Prescription Medication Services:

· Contractor shall set up network & account with local pharmacies near event location.

· Upon need of dentally treated soldiers & recommended by licensed dentist, Contractor to arrange for fulfillment of prescription medication for soldier.

· Contractor shall be invoiced by & submit payment to subcontracted local pharmacy utilized

· Follow-up conversations between Contractor and NCARNG treated soldier & Supervisor may be necessary depending on complexity of treatment and prescription medication, but will always engage Deputy State Surgeon.

· Contractor to collect & tally all expenses of prescription medication services & case management related

· Contractor shall submit costs to the COR.

5.6 Documentation:

· The contractor shall ensure that all appropriate DA or DD forms (in accordance with references) are utilized for each service supplied. The forms will be made available through the North Carolina Army National Guard Medical Command office. The contractor shall provide all documentation concerning medical treatment to the NCARNG Deputy State Surgeon.

· Reporting: The contractor shall provide a final report for all services provided to include a by name, unit, and social security number roster of all soldiers receiving services. The report shall be approved and verified by the NCARNG liaison with the office of the G1/Deputy State Surgeon of the NCARNG.

The following data elements will be reported at the end of an event:

Date Location List of contract employees Total number of patients scheduled Total number of patients examined Verification of entry into all necessary MODS modules (MEDPROS & e-PHA, HRR, etc).

A by name listing of all Soldiers examined and the dental classification of the Soldier (if dental services were requested) The provider shall document the results on the same day examinations are performed.

5.7 Electrocardiogram Testing:

· The contractor shall conduct electrocardiogram testing on all Soldiers as required IAW prescribed Army and NGB policy and IAW AR 40-501for Periodic Health Assessment and Physical Exams (Over 40 years, flight, and Specialty Schools).

· All electrocardiogram testing services shall be provided on location and loaded into HRR.

5.8 Phlebotomy Service:

· The contractor shall perform all Phlebotomy services on location to any Service member requiring the services to include G6PD, PSA, full Lipid Panels, Cholesterol, Sickledex, Hematocrit, and HgB as required IAW prescribed Army and NGB policy and IAW AR 40-501 for Periodic Health Assessment and Physical Exams.

5.9 Eye Exam Testing:

· Eye exams provided on location for all Soldiers scoring worse than 20/40 on vision screening by a certified Optometrist IAW AR 40-501 (if optometry services are requested).

5.10 DNA and ABO-Rh:

· Testing provided on location as required by AR 40-501.

5.11 HIV

· The contractor shall perform HIV tests to all Soldiers requiring as required IAW prescribed Army and NGB policy and IAW AR 40-501.

· All phlebotomy service required for HIV testing must be provided on location and specimens shipped to the CDD.

5.12 IMMUNIZATIONS

· The contractor shall identify through MEDPROS immunizations required for each Soldier then administer necessary vaccines IAW AR 40-562, TB MED 114, Army and NGB policy.

· The contractor shall utilize all MILVAX and AR 40-562 requirements for the transportation and storage of vaccines.

· All immunization services must be provided on location.

5.13 HEARING

· The contractor shall conduct hearing test IAW DA PAM 40-501 in a certified booth using DOEHRS approved equipment.

· The booth and equipment will be provided by the contractor unless otherwise specified in the solicitation.

· The current audiometric booth certification must be posted on the outside of the booth in an easily seen location or available for review.

PART 6

APPLICABLE PUBLICATIONS

6.1 Publications applicable to this PWS are listed below.

· AR 40-501 Standards of Medical Fitness

· NGB Memorandum Post Deployment Health Re-Assessment Screen (attached)

· NGB Memorandum Periodic Health Assessment Interim Guidance (attached)

All publications listed are available via the Internet at the specified web address. (http://www.usapa.army.mil/)

TECHNICAL EXHIBIT 1

Performance Requirements Summary The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each item.

Health Assessments (5.1, 5.2)

Visual Acuity Testing (5.3)

Management of Profiles (5.4)

Prescription Management (5.5)

Administrative Functions (5.6)

Electrocardiogram Testing (5.7)

Phlebotomy Services (5.8)

Eye Exam Testing (5.9)

DNA and ABO-Rh Testing (5.10)

HIV Testing (5.11)

Immunizations (5.12)

Hearing (5.13)

Performance Work Statement (PWS) For Dental Restorative Care

PART 1

GENERAL INFORMATION

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, tools, materials, supervision, and other items and non-personal services necessary to perform Dental Restorative Care as defined in this Performance Work Statement except as Specified in section C-3 as government furnished property and services within the state of North Carolina. The contractor shall perform to the standards in this contract.

1.2 Background: The North Carolina Army National Guard (NCARNG) recognizes the importance of Soldiers’ Dental Readiness. Individual Medical Readiness (IMR) and Fully Medically Ready (FMR) are the basic principles of force sustainment. Dental health is vital for force health protection and failure to achieve a standard level of oral health may preclude a Soldier from deployment status. The performance work statement includes the components of dental classifications for the Department of Defense (DOD) in order to identify varying degrees of dental health and readiness. This is to cover the various components of IMR/FMR to include; annual dental exams, digital bitewings radiographs, digital panoramic radiographs, DENCLASS data entry of all radiographs and dental records, identification and treatment (no less than 90+%) of all Class 3 soldiers eligible for treatment. Services are to be completed on site at NCARNG Armories & Training Sites across the State. The SOW identifies the purpose of the work to be performed by the contractor and provides a description of the work to be completed and any required outcomes. The contractor shall provide qualified personnel, material to perform the services, and /or OSHA, HIPPA, ADA, and Privacy Act Compliant Mobile, Self-Contained Dental Practices depending on the individual site needs for the NCARNG.

DoD established a uniform dental classification in HA Policy 02-11. DoD policy requires dental screening examinations and remediation to be accomplished and documented on 90%+ of service members. Members of the NCARNG shall receive an annual dental screening examination to determine their dental classification. The initial results of that screening examination shall be entered into the DENCLASS database on the date of examination. Final data input by the contractor will be completed within 48 hours of state approval of the proposed treatment. The DENCLASS database updates the Army Medical Protection System, MEDPROS. Dental treatment that may be required is essential to be provided at the SRP site to ensure the highest Dental Deployable Rate for the Mobilizing Soldiers.

1.3 Objectives:

· Conduct and complete FULL Restorative Care for the requirements of the NCARNG mobilizing and non-mobilizing Soldiers

· Conform to the standards of HIPPA, Privacy Act, and OSHA-Complaint mobile dental facility

· Dental services to be performed by licensed dental professionals

· Input to Medical Protection System (MEDPROS)

· Input to DENCLASS

· Upon completion of each event, must submit a detailed list of services performed

· Submit a DENCLASS and MEDPROS input summary report

1.4 Scope:

The scope of this contract is to fulfill the requirements of NCARNG IMR/FMR - Dental Readiness on all eligible (mobilizing or not) Service Members (SMs) in the NCARNG utilizing an HIPPA, Privacy Act, and OSHA-Compliant mobile health facility. Dental services shall be performed by licensed professionals with oversight by the NCARNG Office of the State Army Surgeon. As well, the NCARNG Soldiers that are Class 3 Dental Status (non-deployable without approved dental treatment) require OSHA & ADA-Compliant dental treatment.

1.5 Period of Performance: See established Clins for period of performance per location

1.6 General Information

1.6.1 Quality Control: The contractor shall develop and maintain an effective quality control program 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 quality control program is the means by which he assures himself that his work complies with the requirement of the contract. As a minimum, the contractor shall develop quality control procedures that address the areas identified in Technical Exhibit 1, “Performance Requirements Summary”. After acceptance of the quality control plan the contractor shall receive the contracting officer’s acceptance in writing of any proposed change to his QC system.

1.6.2 Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must 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 the minimum acceptable defect rate(s).

1.6.3 Government Remedies: The contracting officer shall follow FAR 52.212-4, “Contract Terms and Conditions-Commercial Items” or 52.246-4, “Inspection of Services-Fixed Price” for contractor’s failure to perform satisfactory services or failure to correct non-conforming services.

1.6.4 Recognized Holidays: The contractor is required to perform services accordingly except on these Holidays:

1.6.5 Hours of Operation/Place of Performance: The contractor is responsible for conducting restorative Care upon request between the hours of 0700-1900 on any required day of the week, except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. The Contractor must at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this statement of work when the Government facility 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.

1.6.6 Travel Requirements: Contractor will be fully responsible for the travel and all expenses for their staff. Travel is only limited to all and any duty station within the state of North Carolina.

1.6.7 Qualifications: Contractors must have a full understanding of Individual Medical Readiness (IMR) and Fully Medically Ready (FMR) in order to provide services to the NCARNG Soldiers. They must know the requirements of Dental Readiness for the state of North Carolina and be proficient with DENCLASS and MEDPROS.

· HIPAA certified

· Privacy Act

· OSHA & ADA compliant

1.6.8 Special Qualifications: The contractor is responsible for ensuring that all staff members are certified dental professionals. All dental assistants and staff shall be trained and professional with good morals and ethics.

1.6.9 Security Requirements: The contractor shall be responsible for safeguarding all government property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

1.6.10.1 Key Control. (If Necessary) The Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE: All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated. The Contractor shall develop procedures covering key control that shall be included in the Quality Control Plan. 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 duplicate keys/key cards to the Contracting Officer.

1.6.10.1.1. In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the Contracting Officer, 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 replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

1.6.10.1.2. The Contractor shall prohibit the use of 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 Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

1.6.10.2 Lock Combinations. (If necessary) The Contractor shall establish and implement methods of ensuring that all lock combinations are not 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 Quality Control Plan.

1.6.10.3 Conservation of Utilities. 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.

1.6.11 Contracting Officer Representative (COR): The (COR) is identified below:

Primary: MAJ Brian E. Savage, North Carolina Army National Guard Deputy State Surgeon G1- JFHQ, 919-664-6222 email brian.e.savage.mil@mail.mil Alternate: CPT Michelle Pruitt, North Carolina Army National Guard HSS G1- JFHQ, 919-664-6869 email michelle.d.layton.mil@mail.mil

The COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.6.12 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.

1.6.13 Identification of Contractor Employees: All contract 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 in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed. (Indicate if contractor personnel will be required to obtain and wear badges in the performance of this service)

1.7 Security Training Requirements:

1.7.1 Base security will require all employees and affiliated personnel of the contractor to carry a State recognized identification card or drivers license and all vehicles are subject to search without reason. The contractor shall comply with all installation security requirements.

1.7.2 AT Level 1 Training: All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training. The contractor shall obtain and have on file all certificates of completion for each affected contractor employee and subcontractor employee and must be able to provide copies whenever required to the COR or to the contracting officer. AT level I awareness training is available at the following website: https://atlevel1.dtic.mil/at.

1.7.3 Access and General Protection/Security Policy and Procedures. This standard language text is for contractor employees with an area of performance within an Army controlled installation, facility or area. Contractor and all associated sub-contractors employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also 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. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

1.7.4 iWATCH Training. This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR.

1.7.5 Contractor Employees Who Require Access to Government Information Systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

1.7.6 For Contracts that Require OPSEC Training. Per AR 530-1, Operations Security, new contractor employees must complete Level I OPSEC training and must complete annual OPSEC awareness training.

1.7.7 For Information assurance (IA)/information technology (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 .

1.7.8 For information assurance (IA)/information technology (IT) cortication. Per DoD 8570.01-M , DFARS 252.239.7001 and AR 25-2, the contractor employees supporting IA/IT functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M must be completed upon contract award.

PART 2

DEFINITIONS & ACRONYMS

(This section includes all special terms and phrases used in the PWS. The definition must clearly establish what is meant. Each definition provided should be carefully considered, for that definition becomes binding for all requirements in the contract. This section should also contain a complete listing of all acronyms used, giving both the acronyms and the words represented by the acronym).

PWS – Performance Work Statement Contracting Officer’s Representative (COR): A representative from the requiring activity assigned by the Contracting Officer to perform surveillance and to act as liaison to the contractor CCE– Contracting Center of Excellence Defective Service. A service output that does not meet the standard of performance associated with it in the Performance Work Statement.

Quality Assurance Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

Quality Control. Those actions taken by a contractor to control the performance of services so that they meet the requirements of the PWS.

Quality Assurance. Those actions taken by the government to assure services meet the requirements of the Performance Work Statement.

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3.1 GENERAL: Only parking will be provided for HIPAA, Privacy Act, OSHA & ADA-Compliant, Self-Contained Mobile Medical/Dental Practices. No inside armory, TMC, or office space will be provided or utilized without prior approval from the Office of the Deputy State Surgeon.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4.1 General: Except for those items specifically stated to be government furnished in Part 3, the contractor shall furnish everything required to perform this PWS.

PART 5

SPECIFIC TASKS

5.1 Digital Bitewings, Digital Panoramic Radiographs & Dental Exams: The contractor shall perform required dental examinations to include digital bitewings and digital panoramic radiographs if clinically indicated in support of the annual dental screenings in accordance with the AR 40-501 and AR 40-35 in an undetermined number of Armories and training sites in North Carolina to be determined in each delivery order. The contractor must use HIPAA, Privacy Act, OSHA & ADA-Compliant Mobile Dental Practice or Portable Dental equipment. The contractor shall have experience in and capability to upload all exam and digital radiographs into the DENCLASS system. The contractor shall ensure all soldiers have a current Panoramic Radiograph on file and if missing, the contractor shall perform new radiographs. Adherence to all OSHA requirements, State and Federal Regulations are mandatory. Film or ‘digitized’ radiographs will not be accepted (see Technical Exhibit 1).

Exam. A periodic oral evaluation shall assess the current state of oral health, risk for future dental disease as well as assessing general health factors that relate to the treatment of the patient. The following measures are required for each periodic oral evaluation:

a. Caries risk assessment – Classify Soldiers as low, moderate or high risk for caries as outlined by the American Dental Association’s 2009 Special Supplement. This assessment will allow the ADCS to identify those at high risk for future disease and appropriately manage their care.

b. Periodontal assessment – Periodontal Screening and Recording (PSR), a screening procedure endorsed by the American Dental Association and the American Academy of Periodontology, should be utilized to determine the need for periodontal treatment.

c. Tobacco risk assessment – Classify Soldiers as a smoker, user of smokeless tobacco or as both.

d. Oral cancer screening – Perform a thorough oral cancer screening on all beneficiaries as part of all annual examinations.

e. Digital radiographs should be taken only for clinical reasons according to FDA guidelines as determined by the patient’s dentist. Radiographs should be of diagnostic quality, properly identified and dated. A panograph is required to be present in dental record and that it is of adequate quality for diagnostic/identification purposes. There is no time requirement on updating panographic radiographs. However, the panographic radiograph will adequately represent the current oral condition of the Soldier. Digital radiographs shall be performed on all service members who do not have a Panograph on file in the DENCLASS system, regardless of when the hardcopy panograph is dated.

Each exam shall be entered into the DENCLASS reporting system and annotated on the SF 603 (Health Record – Dental) and the SF 5570 (Health Questionnaire for Dental Treatment) of the Soldier’s dental records.

Setup of contractor’s dental equipment is to be completed the day prior to event commencement.

Setup of contractor’s dental equipment is the sole responsibility of the contractor.

Breakdown of the contractor’s dental equipment is the sole responsibility of the contractor.

As required provide timely feedback and work progress/ status of number of Dental examinations completed to the Office of the State Army Surgeon’s POC (or designated representative) as to timelines or factors that may negatively impact processing 8 Soldier exams per hour.

Provide completion status to Office of the State Army Surgeon’s POC (or designated representative) as to time requirements to complete jobs to insure processing 8 Soldier exams per hour.

Contractor must notify the Office of the State Army Surgeon’s POC (or designated representative) at the end of the event.

Electronic entry of data into the DENCLASS database is required by the close of business on the day of the exam. All follow-up DENCLASS database entries will be entered within 48 hours of the States initial approval of treatment plans.

Contractor will have an in house…