Attachment_1-_Performance_Work_Statement_as_of_10-24-2018.pdf

Performance Work Statement (PWS)

For Medical Readiness

In Support of Individual Medical Readiness (IMR) and

Fully Medical Ready (FMR)

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Individual Medical Readiness (IMR) and Fully Medically Ready (FMR) service as defined in this PWS.

1.2 Background Individual Medial Readiness (IMR) and Fully Medically Ready (FMR) are the basic principles 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.

1.2.1. The objective of this Performance Work Statement (PWS) is to conduct and complete the various components of IMR/FMR, Medical and Dental Readiness on all eligible Service Members (SM) of the MEARNG. Services are to be completed on location at various MEARNG Armories & Training Sites across the State. The contractor shall provide all personnel, equipment, tools, materials, supervision, and other items and non-personal Medical or Dental services for Soldiers in the Maine Army National Guard as defined in this Performance Work Statement (PWS). The contract will utilize Government Space or provide OSHA, HIPPA, ADA, and Privacy Act Compliant Mobile/Portable, Self-Contained Health Practices depending on the individual site needs for the MEARNG. See Estimated Workload Data – Technical Exhibit 3.

1.2.1.1 The contractor shall conduct Periodic Health Assessments (PHA)s in accordance with AR 40-501 and the PHA guidance set forth by the National Guard Bureau of the Surgeon General. Compliance with OSHA, State & Federal Regulations is mandatory.

1.2.1.2. Medical Services shall include but not limited to: Blood Pressure, height & weight, Periodic Health Assessments (PHAs), IAW AR 40-501. Laboratory / phlebotomy work such, G6PD, PSA, Immunizations required for IMR and theater specific compliance such as Hepatitis A/B, TwinRex, Influenza and PPD.. Behavioral Health screenings, including review of EPHA answers of SM. Pre-event coordination with MEARNG team members shall be conducted to validate event requirements at thirty

(30) and fifteen (15) calendar days prior to event.

1.2.2. Medical Protection systems (MEDPROS) data entry of all applicable and appropriate IMR/FMR functions with on location data entry or with approval of the MEARNG DSS or Designee data entry not to exceed 5 calendar days after the last day of services. Preference is at the end of the event.

1.2.3. DoD established a uniform dental classification in HA Policy 02-11. DoD policy requires dental screening examinations and remediation to be accomplished as needed and documented on all service members. Members of the MEARNG shall receive an annual dental screening examination to determine their dental classification, including, digital bitewings radiographs and digital panoramic radiographs. Only the soldiers alerted and on Mobilization Orders are eligible for Dental Treatment if they are Class 3 Status from examination. Identification and treatment of ALL Class 3 soldiers on alert orders and eligible. Other Class 3 soldiers are to be treated if time allows. The results of that screening examination and radiographs and dental records shall be entered into the DENCLASS database through the Army Selected Reserve Dental Readiness System (ASDRS) Program. 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. The MEARNG Deputy State Surgeon or Designee shall alert the Contract Event Manager in such cases.

1.3 Period of Performance (PoP): The Period of Performance shall be from 1 December 2018 through 3 March 2019.

1.4 General Information:

1.4.1 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary (PRS).

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 United States (US) holidays.

The contractor shall not perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King, Jr.’s Birthday

1.4.3.3 President’s Day

1.4.3.4 Memorial Day

1.4.3.5 Independence Day: July 4th

1.4.3.6 Labor Day

1.4.3.7 Columbus Day

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day

1.4.3.10 Christmas Day: December 25th

1.4.4 Place and Performance of Services: The contractor shall provide services between the hours of 0700-1800 on PHA weekends specified in the contract performance. Specific services are required at various location throughout Maine (See Event Schedule)

1.4.4.1 Performance Period: The Performance period is specific to each event location (See Event Schedule)

1.4.4.1.1 Telework: Reserved

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, 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 appointed at the time of award.

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 https://www.dmdc.osd.mil/tass/ 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 http://www.us.army.mil/ strategy and their actions affect the most vulnerable portion of the Army Enterprise Infostructure (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). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

1.4.5.6 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 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 of 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 https://informationassurance.us.army.mil/ http://jko.jten.mil/courses/atl1/launch.html

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://ia.signal.army.mil/DoDIAA/).

1.4.5.9 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program. This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR, within 15 calendar days after completion of training.

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 their reporting for duty 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. Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.

1.4.5.11 OPSEC SOP/Plan. The contractor shall develop an OPSEC Standard Operating Procedure (SOP)/Plan and provide it to the COR within 90 calendar days of contract award, to be reviewed and approved by the responsible Government OPSEC officer, per AR 530-1, Operations Security. This SOP/Plan shall include a process to identify the government's critical information, why it needs to be protected, where it is located, who is responsible for it, and how to protect it. The contractor shall implement OPSEC measures as required by the Government. In addition, the contractor shall identify an individual who will be an OPSEC Coordinator. The contractor shall ensure this individual becomes OPSEC Level II certified within 90 days of appointment as OPSEC coordinator in accordance with AR 530-1. Contractor shall provide a copy of the certification to the COR NLT 15 days after completion.

1.4.5.12 Classified Information: Reserved

1.4.5.13 Threat Awareness and Reporting Program (TARP).Reserved

1.4.6 Physical Security. The contractor shall safeguard all Government property https://atc.us.army.mil/iastar/index.php https://ia.signal.army.mil/DoDIAA/ http://cdsetrain.dtic.mil/opsec/ 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: Reserved

1.4.6.2 Lock Combinations: Reserved

1.4.7 Special Qualifications: 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.

1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO.

The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities. Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed.

1.4.11. 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 Contractor Travel: 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.

1.4.15 Phase In / Phase Out Periods: Reserved

2.0 Definitions and Acronyms:

2.1 Definitions:

2.1.1 Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2 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 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 PWS.

2.1.5 Deliverable: Anything that can be physically delivered and includes 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 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 ensure 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.

2.2 Acronyms:

AEI Army Enterprise Info structure AKO Army Knowledge Online ANSI American National Standards Institute AR Army Regulation BI Background Investigation CAC Common Access Card COR Contracting Officer Representative

DA Department of the Army DD Department of Defense DEERS Defense Enrollment Eligibility Reporting System DFARS Defense Federal Acquisition Regulation Supplement DODM Department of Defense Manual DOEHRS Defense Occupational and Environmental Health Readiness System DSS Deputy State Surgeon ECASE Electronic Case Management and Reporting Application EKG Electrocardiogram testing FMR Fully Medically ready HIPPA Health Insurance Portability and Accountability Act HRR Health Readiness record HSPD Homeland Security Presidential Directive IAW In accordance with IA Information Assurance IMR Individual Medical Readiness IS Information System(s) KO Contracting Officer MEARNG Maine Army National Guard MEDCHART Medical Electronic Data for Care History and Readiness Tracking MEDDET Medical Detachment MEDPROS Medical Protection systems MMRB Medical MOS Retention Board MODS Medical Operational Data Systems MWDE MEDPROS Web Data Entry NACI National Agency Check with Inquires NGB National Guard Bureau OCI Organizational Conflict of Interest OSHA Occupational Safety and Health Administration PHA Periodic Health Assessment PII Personally Identifiable Information PIPO Phase In/Phase Out PIV Personnel Identity Verification POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QASP Quality Assurance Surveillance Plan QCP Quality Control Plan RAPIDS Real-Time Automated Personnel ID system SPRINT Speech Recognition in Noise Test SRC Soldier Readiness Check SRP Solider Readiness Processing STR Soldier Treatment Record TASS Trusted Associate Sponsorship system TMC Troop Medical Clinic

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S):

The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1 Property: The MEARNG shall provide the building or office required for the requested activity to include tables and chairs and 110v household outlets. No Armory, Troop Medical Center (TMC) or office space shall be utilized unless approved by the Government. For Armory Space Events, coordination with the Office of the Deputy State Surgeon prior to the setup for each event is required.

3.1.1. The Government will provide an administrative space for soldier check-in and out and vision run/space for vision tests for all events.

3.1.2. Only parking will be provided in events identified as mobile/portable

3.2. Materials: Contractor shall provide mobile facilities and equipment to support required service (i.e. hearing booth, dental equipment for treatment, ect.)

3.3 Equipment: Reserved

3.4 Services: The MEARNG shall supply flu shots and vaccines for soldiers. The contractor shall be responsible for providing expendable supplies and personnel to administer vaccines.

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

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

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

4.1.2 The contractor shall provide all material, equipment, and supplies necessary to provide all listed service requirements listed in the event schedule in either mobile/portable space or inside Government facilities.

4.1.3. Contractors shall provide all necessary mobile/potable events space (see event schedule). Medical & Dental mobile/portable facilities shall meet all OSHA, HIPAA and Privacy Act standards to ensure a safe and productive workspace for services under the Individual Readiness Requirements. Mobile and or portable exam/treatment areas must ensure that privacy is observed for all medical/dental exam rooms. There shall be a designated vitals area, visual acuity area, a lab with eye-wash stations, biohazard separated work areas, hearing booth(s) with ISO-Booth for SPRINT testing, all emergency medical resources consistent with OSHA and a large reception area with full office capabilities. X-Ray-Radiograph Rooms shall be compliant with all radiation safety standards.

4.1.4. The Mobile/Portable Medical/Dental areas shall have full treatment functionality consistent with traditional, fixed-site, private practice dental/medical offices. This includes professional quality dental chairs, compressor systems, vacuum systems, and treatment instruments for fillings, extractions, root canals, and other authorized dental treatment. Mobile/portable Medical/Dental Facilities shall be fully functional offices whereby no additional space will be given inside military buildings during events as these events may be in remote areas.

4.1.5. Contractor must have the capability to conduct real-time, point of service E-PHA, HRR, DENCLASS and MEDPROS data upload on location. Data entry shall not to exceed 5 calendar days after event. The contractor shall provide their own mobile internet access for all service events.

4.1.6 The Contractor must have Common Access Card (CAC) enabled Event Managers and support staff. Contractor must be able to do Post-Operatory Panoramic X-rays upon completion of treatment whereby the forensics image will change materially. Also, Contractor must be able to upload images to the Active Duty Dental Repository (ADDRs) system for DENCOM requirements of deployability. All Personally Identifiable Information (PII) will be safeguarded, see DoD Directives 5400.11 and 5400.11-R.

5.0 Requirements: The contractor shall:

5.1.1.MEDICAL SERVICES SCOPE:

5.1.2. The scope of contractor provided Medical Services is to conduct and complete the requirements of IMR/FMR Medical Readiness on all eligible (mobilizing or not) Service Members (SMs). Medical services shall be performed by licensed professionals.

Contractor shall be held liable and is responsible to ensure and verify the appropriate level of Credentialing / Privileging (Licensure, Diploma, background checks, Common Access Card privileges etc.) for all contract providers in support of any service event.

5.1.3. Providers: The contractor shall conduct Periodic Health Assessments (PHA) and other physical exams IAW prescribed Army policy and IAW AR 40-501. The Providers shall have an active CAC card and AKO account. Providers shall enter all data into MODS MHA (PHA Module). Providers shall require access to MODs, eProfile, Ecase, and HRR. The provider shall document the results on the same day examinations are performed. The provider shall get MEARNG provider approval of new Profiles generated. A military provider Liaison will be at every site to facilitate all profiles. The provider shall make all necessary referrals to behavioral health as defined in paragraph

5.11 Medical evaluation by a licensed provider (Physician, Physicians Assistant (PA), or Nurse Practitioner (ARNP). RNs must have completed appropriate training IAW DoD service, USCG, and CDC guidelines and act within their scope of practice.

5.1.3.1. Physical Exams: All professionals shall be licensed and adhere to all requirements of OSHA, State & Federal Regulations is mandatory.

5.1.4. PHA Height, Weight and Vitals: The contractor shall provide trained and certified personnel to measure height, weight, temperature, pulse, respirations, blood pressure and O2 IAW prescribed Army policy and IAW AR 40-501. Data shall be entered into MODs MHA at the event.

5.1.5. Vision Screening: The contractor shall conduct visual acuity testing IAW prescribed Army policy and IAW AR 40-501. The Vision data must be entered into MODs MHA and updated in MWDE at the event. Vision data must be entered on the “Vision Form” and scanned into HRR at the event. MEARNG shall supply the “Vision Form”. Eye exams and prescriptions (DD771s) provided on location for all Soldiers scoring worse than 20/40 on vision screening.

5.1.6. 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, as required IAW prescribed Army policy and IAW AR 40-501 for Periodic Health Assessment and Physical Exams. Lipid Panels, Fasting Glucose and Blood Type must have results ready and available for provider review with the Soldier.

G6PD and PSA results shall be sent to MEARNG MED DET. The contractor shall have a network of local labs for the required specialty tests that cannot be processed on site (G6PD, PSA, Titers, etc). The contractor shall complete the required HIV blood draws and maintain cold chain management of the draws till collected by MEARNG MED DET.

Any results generated must be scanned into HRR and Blood Type results must be entered into MWDE and on the DD2766..\ All routine and theatre specific immunizations administered by contractor when requested in the services delivery schedule must be annotated on a DD Form 2766 .

5.1.7.Immunizations: The contractor shall identify through MEDPROS all routine immunizations required for each Soldier and administer necessary vaccines IAW AR 40-562, Army policy. The contractor shall utilize all MILVAX and AR 40-562 requirements for cold chain management. All immunization services must be provided on location. Date must be entered into MODs MWDE and the SF 601 must be scanned, indexed and approved in HRR. The contractor shall provide routine urinalysis for pregnancy testing as required prior to delivery of specific immunizations that cannot be administered during pregnancy.

5.1.7.1 Immunizations: The contractor shall administer immunizations in accordance with AR40-501.Immunizations shall include, but not limited to, flu, varicella, MMR, yellow fever, typhoid, tetanus, hepatitis A, hepatitis B, and polio. Adherence to all requirements of the OSHA and all State & Federal Regulations is mandatory. In such cases, coordination with MEARNG Medical Command and the Office of the Deputy

State Surgeon (DSS) to order and transport serum to sites will be made. Government will provide serum if it is required for event.

5.1.8. Contractor shall have access to a local pharmacy where prescriptions will be filled in real time and there will be at least one dentist who is legally able to write prescriptions in Maine that can be filled by this pharmacy and paid for by Contractor. Contractor shall provide designated prescription runners on location that will pick up prescriptions and deliver them to the soldier at the PHA site. All prescribed medications will be approved by the State Dental Officer before pick-up. Contractor shall have a control system in place on location for soldier to sign for prescription once delivered to him/her.

Contractor shall be responsible for all pharmaceutical costs up to $1,000 per event. For purposes of this paragraph, each performance location for each month (i.e. each Contractor mobilization per site) shall be considered an event.

5.1.9 Electrocardiogram Testing: (EKG) The contractor shall conduct electrocardiogram testing on all Soldiers as required IAW prescribed Army policy and IAW AR 40-501 for Periodic Health Assessment and Physical Exams (Over 40 years of age, flight, and Specialty Schools). All electrocardiogram testing services shall be provided on location and results printed for provider review and scanned, indexed and app into HRR.

5.1.10. Hearing: (DOEHRS Compatible Audiometer Testing) The contractor shall provide base line and annual audiology in accordance AR 40-501 with a portable hearing test facilities with DOEHRS-compatible Benson CCA 200M systems in ANSI certified hearing booths. Government representatives shall be afforded the opportunity to verify that sound levels meet the ANSI certification standards at the location. All data shall be uploaded into the DOEHRS data base and the DD 2215 or DD 2216 shall be scanned and indexed in HRR. The MEARNG will provide a DOEHRS certified testers to perform actual testing and upload into DOEHRS live. The MEARNG has trained DOEHRS certified Technicians, all of the audiology evaluations and Speech Recognition in Noise Test (SPRINT) testing will be performed IAW all applicable Federal, DoD, MEDCOM, NGB, and State guidelines. Iso-booths to be CAOCH certified. Audiologist / SPRINT testing for all applicable Soldiers.

Audiology H2/H3/H4 and SPRINT testing on location in real time

5.2. Dentist: The contractor shall provide a dentist to perform dental exams in accordance with AR 40-501. All equipment and supplies required for provision of services shall be supplied by Contractor.

5.2.1. Dental Screening: The contractor shall provide customized comprehensive dental readiness services to the MEARNG Service members to include annual dental examinations and clinically indicated radiologic studies (bite-wing x-rays) when requested, and specified treatment outlined in the patient’s treatment plan and IAW AR 40-501 and AR40-35. Upon completion of services, medical information will be documented in accordance with Department of the Army Policy. Reports will be provided to the MEARNG Deputy State Surgeon’s Office. The contractor shall also ensure the requirements of Occupational Safety and Health Administration (OSHA) and applicable federal regulations are met. Dental data shall be entered and X-Rays shall be scanned into DENCLASS.

5.2.2. Dental Treatment: Services include 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 DRC to include: annual dental exams, digital bitewing radiographs, digital panoramic radiographs, DENCLASS data entry of all radiographs and dental records, identification and treatment of all Class 3 soldiers on alert orders and/or eligible (except as Specified in section C-3) through the Army Selected Reserve Dental Readiness System (ASDRS) Program to upgrade Class 3 or Class 4 Soldiers to a Class 2 or 1 status.

5.2.2.1. Treatment. Only treatments that have been identified in the patient’s treatment plan will be accomplished. These treatments are designed to improve the dental classification status of the Soldier from Class 3 to Class 2.

5.2.2.2. Approval for Treatment: The State Dental Officer (or designated representative) will review any dental treatment plan for dental care to insure that the above clinical guidelines are met. Exceptions can be made, but they must be coordinated with the Deputy State Surgeon, State Dental Officer or Designee.

5.2.2.3. The Contractor shall provide dental treatment to those Soldiers evaluated as a DRC3. All treatment plans for conversion from DRC3 to DRC2 shall be approved by the State Dental Officer (SDO) or designated representative. All X-Rays and data shall be scanned into DENCLASS. Contractor shall set up network and account with local pharmacies near event location. Follow-up conversations between Contractor and MEARNG treated soldier and Supervisor may be necessary depending on complexity of treatment and prescription medication, but shall always engage Deputy State Surgeon Contractor to explain post-operatory instructions to soldier and DSS or Designee.

5.2.2.2. Documentation. Documentation of exam and treatments shall be returned to the Maine Army National Guard Medical Representative (Deputy State Surgeon) from the Office of the State Surgeon. The Contractor will return all functional files maintained by the Contractor to the government upon completion of the required services.

5.2.2.3. The Standard Form (SF 603/603A), Record of Dental Exam and treatment shall be completed. Supporting Radiographs (pantograph/four bitewings) if necessary.

5.2.3.4. A diagnostic quality copy of all radiographs shall be placed in the dental record as required.

5.2.2.4. Dental Treatment: Based on National Guard Bureau’s national statistics, it is estimated that 30% of the soldier exams will be Classification 3, Non-Deployable.

Dental restorative treatment is necessary to get Class 3 soldiers to a Class 2 Status, or deployable, before their Mobilization. The Contractor shall provide approved dental treatment only.

5.2.3. Clinical evaluation by a licensed dentist of the oral cavity using visual, clinical exam supported by bitewings taken by certified dental technicians.

5.2.4. Individual case management, accountability and vendor oversight provided by a qualified and credentialed Dental Director (licensed DDS or DMD). This position shall be a staff position of the prime vendor.

5.2.5. Pre-event scrub of records through DENCLASS, ADDRs or CDR

5.2.6. Staff a dedicated and organic emergency 1-800 # (manned 24/7) call line for Soldiers to call, should dental emergencies emerge upon completion of dental work.

5.2.7. Oral surgery on location and Endodontic treatment on location at same time as the event.

5.2.8. “Chair-side” dental classification, entered “real-time” (5 business days from the event if no connectivity) 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.

5.2.9. All access to MODS modules (www.mods.army.mil) will be performed by awarded vendor.

5.2.10 Personnel performing the dental screening examination have a moral and ethical obligation to inform the Soldier if they observe any sign or symptom for which the Soldier should obtain further evaluation or care.

5.2.11 Provide “real-time” pharmacy prescriptions for each restorative event (and qualified staff to obtain medications) for any Soldier requiring medications post-event.

5.2.12. Provide a qualified bio-medical machine technician for each examination and restorative event, in case of equipment failure.

5.2.13. Provide dental screening examination to identify deficiencies (but does NOT include the dental treatment required to restore those deficiencies unless Class 3 status, or in need of full mouth debridement).

5.2.14. Caries Risk Assessment – Classify Soldiers as low, moderate, or high risk for caries as described by the American Dental Association’s 1995 Special Supplement.

This assessment will allow the ADCS to identify those at high risk for future disease and appropriately manage their care.

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

5.2.16. Tobacco Risk Assessment – Classify Soldiers as a smoker, user of smokeless tobacco, both or neither.

http://www.mods.army.mil/

5.2.17. Oral Cancer Screening – Perform a thorough oral cancer screening as part of all examinations.

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