EXHIBIT_1-Performance_Work_Statement_-_Dated_5-29-19.pdf

As of 29 MAY19

PERFORMANCE WORK STATEMENT (PWS)

FOR

Medical and Dental Readiness Services

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified as Government Furnished, to perform Medical and Dental Services, as defined in this PWS. The TXARNG expects the Contractor to provide excellent support by providing the right expertise at the right place at the right time. Mission: The Office of the State Surgeon has the primary responsibility to develop, manage, and execute all medical readiness operations to enhance Texas Army National Guard Initiatives. Our Federal Role: To maintain individually ready, properly trained and equipped units, available for prompt mobilization of war, national emergency, or as otherwise needed. Our State Role: To provide individually ready, trained and disciplined forces for domestic emergencies or as otherwise required by state law.

1.2 Background:

Individual Medical Readiness (IMR) and Medical Readiness Category (MRC) are the basic principles of force-sustainment for Texas Army National Guard (TXARNG) forces.

Medical & dental health is vital for force health protection and failure to achieve a standard level of medical and/or oral health could preclude a Soldier from deploying.

Medical & Dental Readiness is a command responsibility.

Department of Defense established a uniform dental classification in HA Policy 02-11.

National Guard Bureau issued guidance to provide dental treatment to Soldiers outside of alert phase of the Soldier Readiness Model (SRM) by issuing NGB-ARS detailing the Army Selected Reserve (SELRES) Dental Readiness System (ASDRS) policy. DoD policy requires dental screening examinations and remediation to be accomplished and documented on 90%+ of service members. Members of the TXARNG shall receive an annual dental screening examination to determine their dental classification. Soldiers are eligible for Dental Treatment if they are Class 3 Status from examination. Soldiers outside of alert status are also eligible for treatment if they are a Class 3 Status from examination. It is essential to provide Dental Treatment that may be required at the MEDICAL/DENTAL READINESS & SRP site to ensure the highest Dental Deployable Rate for the Non- Mobilizing & Mobilizing Soldiers.

Department of The Army established a requirement for a routine, annual Periodic Health Assessment (PHA) to be conducted for all members of the Active Duty and the Selected Reserves. This program focuses on optimizing the health and wellness of Soldiers.

1.3 Period of Performance (PoP): The Period of Performance shall be 1 Base Year of 12 months and 3 12-month option years.

1.4 General Information:

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 to be determined based on event needs. Contractor shall be able to respond within a minimum of 3 days’ notice anywhere within the state of Texas. Services may be required out-of-state across the country should the TXARNG be training outside the state. An exception to the previously stated is on recognized US holidays; or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Performance shall be determined on each delivery order. Event operation hours shall be in three-hour blocks up to four consecutive blocks not to exceed four consecutive blocks per day, unless special arrangements are made.

The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/ installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential.

1.4.4.1 Telework: Not authorized.

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.

Installation security shall require all employees and affiliated personnel of the Contractor to carry a State recognized identification card or driver’s license and all vehicles are subject to search without reason. The Contractor shall comply with all installation security requirements. 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, an SF 85, an OF306, and finger printing 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 State G2 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: (TA is TBD)

2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO.

The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at:

https://www.dmdc.osd.mil/tass/. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.

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

a. Approval. *Upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their CAC.

The contractor proceeds to a RAPIDS station (RAPIDS Site Locator:

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

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

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

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

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

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

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

KO.

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

1.4.5.2 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.

1.4.5.3 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the Army Enterprise 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:

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

1.4.5.3.2 The Contractor shall provide an Enterprise System that is CLIENT ACCESSIBLE to obtain operational details, insurance information, live event tracking and automatic status e-mail updates.

1.4.5.3.3 Contractor shall be able to replace faulty IT equipment within 24 hours.

1.4.5.3.4 Provide the capability to accomplish Electronic Periodic Health Assessments (ePHA) to include the hardware and on-installation technical support on operating systems developed after 2001, i.e. Windows XP or Windows 2010, on a stand alone internet system separate from the TXARNG.

1.4.5.3.5 Contractor shall be able to demonstrate a plan that includes 24/7 IT Support.

1.4.5.3.6 Contractor shall have the capability to maintain full electronic medical/dental records.

1.4.5.3.7 Contractor shall have the capability to track Soldiers through an electronic process that provides for the ability to search both during and post event.

1.4.5.3.8 Contractor shall have the capability to conduct electronic, automated upload of medical/dental information to military reporting endpoints to include DENCLASS, MEDPROS, HRR, ePHA and eProfile.

1.4.5.3.9 Contractor shall have the capability of providing point of service ePHA data entry for the SMs portion of the ePHA.

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

1.4.5.3.11 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.

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

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

1.4.5.4 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.

1.4.5.5 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 .

1.4.5.6 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 DoD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.

1.4.5.7 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/).

1.4.5.8 iWATCH Training: Reserved.

1.4.5.9 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/.

1.4.5.10 OPSEC SOP/Plan. Reserved

1.4.5.11 Classified Information. Reserved.

1.4.5.12 Threat Awareness and Reporting Program (TARP). Reserved.

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

1.4.6.1 Key Control. Reserved.

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

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

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

1.4.6.2 Lock Combinations: Reserved.

1.4.7 Special Qualifications: Medical services shall be performed by licensed medical professionals with oversight by the TXARNG, Office of the State Surgeon. Providers requiring licenses shall be licensed in accordance with Army Regulation 40-68, para. 4-8.

Army Regulation 40-68, para 4-8 states, “… U.S. based non- personal services contracted providers, in all disciplines, will be licensed by the State or jurisdiction in which they are providing services”. Dental services shall be performed by licensed medical professionals. All PHA events shall be performed by licensed and certified medical professionals. 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 contract providers in support of any TXARNG event.

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: Reserved.

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: Reserved.

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 Dental Classification (DENCLASS): An approved ARNG web-based module (through MEDCHART) designed to standardize the court of dental classifications, eliminate duplicate data system entry, facilitate the dental exam workflow, standardize the documentation of the health history and record of dental exam and integrate dental readiness within the Medical Operational Data Systems (MODS) architecture. The DENCLASS module has been designed to document the dental readiness requirements of all ARNG Soldiers. Components of DENCLASS include; an automated health history, an automated SF603A, an automated letter outlining the dental treatment plan, a repository for dental radiographs, a library of Dental readiness policy and statistical reporting of all components of DENCLASS.

2.1.7 Individual Medical Readiness (IMR): is defined as being free of health-related conditions that limit a Soldier’s ability to actively fulfill his/her assigned mission. Individual Medical Readiness consists of six elements: Dental Readiness, Immunization Status, Periodic Health Assessment (PHA), No deployment limiting conditions, Medical Readiness Laboratory Tests (HIV testing, DNA sampling, G6PD test), and Individual Medical Equipment (Eyeglasses, hearing protection). When all of these factors are considered, the individual Soldier is classified as:

GREEN – Fully Medically Ready. Current in all categories including Dental Class 1 or 2.

AMBER – Partially Medically Ready. Lacking one or more immunizations, readiness laboratory studies, or individual medical equipment. Needs an element that can be corrected prior to mobilization.

RED – Not Medically Ready. Existence of a chronic or prolonged deployment limiting condition (per Service-specific physical standards guidelines), including Service members who are hospitalized or convalescing from serious illness or injury, or individuals in dental class 3. Has a limiting condition that requires hospitalization or required medical care not available in the theater of operation.

Medical readiness indeterminate. Inability to determine the Service member‘s current health status because of missing health information such as a lost medical record, an overdue PHA or being in dental class 4.

2.1.8 End of Event Summary: A summary that includes detailed information from the start of the event listing all numbers, classifications and types of services provided.

2.1.9 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.

2.1.10 The Medical Operational Data System (MODS) (http://www.mods.army.mil) is an MHSS objective system that provides the Army Medical Department (AMEDD) with an integrated automation system that supports all phases of Human Resource Life-Cycle Management in both peacetime and mobilization. This on-line system provides commanders, staffs and functional managers of AMEDD organizations with a real time source of information on the qualifications, training, special pay and readiness of Army Medical Department (AMEDD) personnel. MODS currently maintain sixty system interfaces which are updated on a daily, weekly, monthly or semi-annual basis. These interfaces bring in over 75% of the data used in the system. The AMEDD community has a powerful tool with which decision makers and managers can affect their work requirements quickly. As a desktop resource for the personnel manager, MODS places critical assignment, training and qualification information at his fingertips. Time spent acquiring data can now be used in analyzing the information.

2.1.11 Medical Protection System (MEDPROS): The MEDPROS (available through MODS) was developed by the AMEDD to track all immunization, medical readiness and deploy ability data for all Active and Reserve components of the Army as well as DA Civilians, Contractors and others. The comprehensive Medical Readiness data includes all medical and dental readiness requirements, IAW AR 600-8-101. They include immunizations, permanent physical profiles/duty limitations, eyeglasses/inserts, blood type, medical warning tags, personal deployment meds, pregnancy screening, DNA, HIV and dental status among othedata elements.

2.1.12 Periodic Health Assessment (PHA): An annual assessment for changes in health status, especially those that could impact a member‘s ability to perform military duties.

2.1.13 Physical Security: Actions that prevent the loss or damage of Government property.

2.1.14 Quality Assurance: The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

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

2.1.16 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements. The Contractor shall create a quality assurance program that monitors all services being provided. The program shall be approved by the TXARNG.

2.1.17 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:

AAR After Action Review ADA American Dental Association AEI Army Enterprise Infostructure AR Army Regulation ARNG Army National Guard ARNP Army Nurse Practitioner AT/OPSEC Antiterrorism/Operational Security ASDRS Army Selected Reserve Dental Readiness System BI Background Investigation CAC Common Access Card CLIA Clinical Laboratory Improvement Amendments CM Contract Manager CMRA Contractor Manpower Reporting Application COR Contracting Officer Representative DA Department of the Army DD254 Department of Defense Contract Security Classification Specification DENCLASS Dental Classification DENCOM US Army Dental Command DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense DTR Dental Treatment Record FAR Federal Acquisition Regulation

HIPPA Health Insurance Portability and Accountability Act GFP/M/E/S Government Furnished Property/Material/Equipment/Services HQDA Headquarters, Department of the Army HRR Health Readiness Record HSPD Homeland Security Presidential Directive IA Information Assurance IAW In Accordance With IMR Individual Medical Readiness IS Information System(s) IT Information Technology KO Contracting Officer MEDCHART Medical Electronic Data Care History And Readiness Tracking MEDPROS Medical Protection System MHA Medical Health Assessments MODS Medical Operational Data System NCOIC Non Commissioned Officer In Charge MRC Medical Readiness Category NGB National Guard Bureau NOSTRA Naval Ophthalmic Support and Training Activity NP Nurse Practitioner OCI Organizational Conflict of Interest OD Doctor of Optometry OSS Office of the State Surgeon OSHA Occupational Safety and Health Administration PHA Periodic Health Assessment PII Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact POS Point of Service PRS Performance Requirements Summary PSR Periodontal Screening and Repair PWS Performance Work Statement QA Quality Assurance QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program RDA Registered Dental Assistant SELRES Army Selective Reserve SMRC Soldier Medical Readiness Center SRC Soldier Readiness Check SRP Soldier Readiness Processing SRTS Spectacle Request Transmission System SSN Social Security Number STR Soldier Treatment Record TE Technical Exhibit TXARNG Texas Army National Guard USD(I) Under Secretary of Defense for Intelligence USPSTF US Preventive Services Task Force

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 if detailed as available in the delivery order:

3.1 Property: The Government shall provide parking for HIPAA, Privacy Act, OSHA & Radiological-Compliant, mobile platform, Medical/Dental Practices. Contractor will have the ability to operate the event with only parking space provided by Government.

Armory, SMRC or office space will be utilized when advantageous to Government and determined on Task Order.

Routine Adult immunization serums to be determined on each delivery order.

Contractor shall utilize the Texas ARNG Medical Detachment for all HIV and DNA supplies, shipping supplies, and shipping guidance.

3.2 Materials: Reference 3.0.

3.3 Equipment: Reference 3.0.

3.4 Services: Reference 3.0.

3.5 Utilities: All utilities in the facility will be available for the contractor’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, dependent upon the delivery order, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

5.0 Requirements: The contractor shall:

5.1. Contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control needed to perform the IMR requirements. In accordance with Army Regulation 40-68, para. 4-8, contracted providers, in all disciplines, must be licensed by the State of Texas.

5.2 Mobile Dental and Medical Platforms shall be IAW Occupational Safety and the Health Act of 1970 (Part 1910), Subpart E Regulations Standards 29 CFR. Mobile Dental and Medical Platforms shall meet all OSHA, ADA, Privacy Act & HIPAA standards to ensure a safe and productive workspace for medical services under the Individual Readiness Requirements.

Mobile Dental and Medical Platforms shall be a fully functional work space whereby no additional space shall be given inside military buildings during events, as these events may be in remote areas such as artillery ranges.

5.2.1 The Mobile Dental and Medical Platforms shall provide radiograph radiation protection, digital bite-wing and panoramic equipment to provide digital radiography files at the end of the event, all emergency medical resources consistent with OSHA such as eye-wash station, distilled water tanks, three separate and walled dental operatories to provide confidentiality for patients and individual temperature controlled rooms consistent with OSHA standards. The Contractor’s Safety Program shall be IAW OSHA Standards Emergency Action Plans, (1910), Subpart E, e-CFR, Means of Egress. The Contractor‘s safety program includes equipment training, occupational safety, health, and fire protection guidance to ensure the protection and health of all work personnel.

5.2.2 Mobile Dential and Medical Platforms shall include and be capable of providing the following:

5.2.2.1 Fully equipped Private Exam Rooms for full PHA & Physical Exam Requirements.

(Cannot be an "open-bay" examination room setup; shall be HIPAA-Compliant & confidential for patient)

5.2.2.2 Health Stations to include vital signs, Visual acuity, tonometry, DRE (Digital Rectal Exam), Hemoccult, immunizations, PPD screenings, HIV Blood-Draws, DNA collection, DOEHRs –Compliant audiometry, and all other MEDICAL/DENTAL READINESS requirements.

5.2.2.3 Lab with eye-wash stations

5.2.2.4 Biohazard separated work areas

5.2.2.5 A sufficient size reception area with full office capabilities to accommodate continuous flow of patient services

5.2.2.6 Have appropriate climate control and ventilation system to reduce airborne pathogens.

5.2.2.7 DOEHRS Compatible Audiometer

5.2.2.8 TITMUS Visual Acuity Screener

5.2.2.9 CLIA – Waived Rapid Laboratory Screenings (Lipid Profile, PT/INR, BNP, CK, CKMB, BMP,CHEM 8, Hemoglobin Blood Glucose, Total Cholesterol, Urinalysis & Urine HCG) and urine Chlamydia screen.

5.2.2.10 Blood Pressure, Pulse Oximetry, Height/Weight/Temperature

5.2.2.11 Optometry with Visual Refraction

5.2.2.12 Ability to Perform Blood Collection for HIV, DNA, G6PD, RPR

5.2.2.13 Ability to Perform Immunizations

5.2.2.14 Ability to perform Women’s Health Exams such as Pap smears, Chlamydia testing, mammograms as required per Women’s Health guidance, and case manage Mammography.

5.2.2.15 Ability to perform DRE (Digital Rectal Exam) and PSA testing for over- fifty male service members

5.2.2.16 Ability to upload audiograms directly into the DOEHRS Repository

5.2.2.17 Contractor is responsible to keep and dispose of all medical waste in accordance with 42 CFR.

5.2.2.18 Ability to provide Tonometry

5.2.2.19 Ability to provide EKG

5.2.2.20 Ability to provide Perform Pulmonary Function Testing Equipment

5.2.2.21 Operatory (Private Exam Room) Radiological-Compliant & Self- Contained mobile platform Dental Practice shall contain/provide:

5.2.2.22 Fully digital Intra-Oral Bite-wing radiographs, Split-Bitewing capable Panoramic X-ray Machine & examinations, provide radiograph radiation protection.

5.2.2.23 Professional grade dental treatment comparable to a fixed-site, traditional dental practice.

5.2.2.24 Professional-grade dental vacuum and compressors to allow general & specialty dental procedures.

5.2.2.25 Ergonomically correct, fully functional dental exam & treatment chairs.

5.2.2.26 Reception area for data intake and outtake within mobile platform Dental Practice for health history and data processing.

5.2.2.27 Reception area shall also have patient education capability, i.e. To Quit Smoking-Smoking Sensation.

5.2.2.28 Meet all state radiological requirements.

5.2.2.29 Separate sterilization area within the mobile platform Dental Practice

5.2.2.30 Fully functional office area that has full printing/copying requirements

5.2.2.31 Equipped with printers that provide Film-Based printing for superior clinical quality and durability of hard copy x-ray

5.2.2.32 Shall contain biohazard waste receptacles

5.2.2.33 Intra-Oral Bitewing Sensors for superior digital image exposure, Kodak preferred

5.2.2.34 Equipped to provide SMs with patient education and shall have a Dental Quality Assurance program/consultant with Military Dental Experience.

5.2.2.35 Portable Dental exam/radiograph equipment shall meet all State radiological standards and requirements.

5.2.3 All vehicles shall be radiological compliant and have sufficient patient walkways to provide comfortable space during heavy utilization events. Internet connectivity shall be available for any mobile platform Health Practice deployed to allow for real-time data entry at events.

5.2.4 Mobile Health Practice shall have capability for real-time, point of service military health records upload. This requires Contractor to have high-speed, broadband or satellite communication channel. The contractor shall have Project Manager and CAC enabled Health Care Providers with Medical Health Assessments access to update Soldier PHA’s in real time. The workstations shall have Bar-Code Scanning capability to ensure high quality standards for data entry. Contractor shall be able to do Post- Operatory digital Panoramic X-rays upon completion of treatment whereby the forensics image shall change materially. Contractor shall be able to upload images to the Active Duty Dental Repository (ADDRs) system for Dental Command requirements of deployability. Contractor shall have live event & Soldier tracking systems in place to report progress of events back to Point-of-Contact at Event as well as for remote tracking.

5.2.5 Setup of Contractor‘s dental equipment shall be completed by the day prior to event commencement. Setup and breakdown of Contractor‘s dental equipment is the sole responsibility of the Contractor.

5.2.6 All vendor property to include mobile platforms needs to be removed within a 24 hour period upon completion of the event. In the case of an emergency such as hurricanes etc. the vendor shall have capability to completely move off the Government site within 5 hours of notice.

5.2.7 Contractor shall notify the COR and event POC via e-mail at the conclusion of each day’s event operations with a summary of the total number of Soldiers scheduled, checked-in, and checked-out for that day.

5.3 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. The Contractor shall upload all exam and digital radiographs into the DENCLASS system. The Contractor shall ensure within five days post event all Soldiers have a current Panoramic Radiograph on file in accordance to NGB standards and if missing, the Contractor shall perform new radiographs.

Adherence to all OSHA/HIPAA/ADA/PRIVACY ACT requirements, State and Federal Regulations are mandatory. Film or digitized radiographs shall not be accepted.

5.3.1 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. Personnel performing the dental screening examination have a moral and ethical obligation to inform the Soldier if they observe or are apprised of any sign or symptom for which the Soldier should obtain further evaluation or care. The following measures are required for each periodic oral evaluation:

5.3.1.1 Caries risk assessment – Classify Soldiers as low, moderate or high risk for caries as outlined by the American Dental Association‘s 1995 Special Supplement. This assessment shall allow the ADCS to identify those at high risk for future disease and appropriately manage their care.

5.3.1.2 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.

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

5.3.1.4 Oral cancer screening – Perform a thorough oral cancer screening.

5.3.1.5 Digital radiographs should be taken only for clinical reasons according to FDA guidelines as determined by the patient‘s dentist. When required, Radiographs shall be of diagnostic quality, properly identified and dated. A panograph is required to be present in dental record and of adequate quality for diagnostic/identification purposes. There is no time requirement on updating panographic radiographs. However, the panographic radiograph shall adequately represent the current oral condition of the Soldier. Digital panograph 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.

5.3.1.6 Provide hardcopy medical documentation review, file and organization in accordance with AR 40-66 into the Soldier Treatment Record (STR). Thermal printers printing film radiographs are preferred.

5.3.1.7 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.

5.3.1.8 Immediately provide feedback and work progress/ status of number of Dental examinations completed to the Office of the State Surgeon‘s POC (or designated representative) when it is determined that timelines or other factors may negatively impact processing 8 Soldier exams per hour.

5.3.1.9 Electronic entry of data into the DENCLASS database is required within 5 days of completion of the Dental Screening event to include the upload of any radiographs taken during the event.

5.4 Dental Treatment: The Contractor shall provide approved dental treatment only within an OSHA & ADA Compliant mobile platform Dental Practice. The goal is for the contractor to convert 90% from Dental Classification 3 to Dental Classification 1 or 2. Soldiers not converted should fall IAW PWS reference 5.1.7. Contractor shall have fully licensed & accredited TX & other State licensed network of general & specialty dental providers that can treat authorized Class 3 TXARNG Service Members. See Technical Exhibit 4 for Dental Classification Information and Technical Exhibit 5 for Authorized and Unauthorized Procedures.

5.4.1 Contractor shall submit all dental treatment plans to the State Dental Officer (or designated representative) for approval prior to treatment. Treatment exceptions can be made, but they shall be coordinated with the State Surgeon.

5.4.2 Post-event Dental Case Management:

5.4.2.1 Post-event dental case management is not to exceed 30 days from the end of the event for Soldiers whose dental status cannot be converted to DRC 1 or 2 on-site.

Soldiers requiring post-event dental case management shall be case-managed by the Contractor based upon an approved dental treatment plan. The Contractor shall arrange for fulfillment of dental treatment for any Soldier requiring these services. Within 24 hours of completion of the event, the Contractor shall provide a by-name roster of all Soldiers that require post-event dental case management to the Office of the State Surgeon.

Contractor shall provide a by-name update upon conversion to DRC 1 or 2. Upon completion of the initial 30 days of post-event dental case management, the Contractor shall invoice for dental case management services provided.

5.4.2.1.1 Contractor shall setup a network of and account with local general and specialty fixed-site dental facilities and offices near event location and/or home of TXARNG Soldier requiring treatment.

5.4.2.1.2 Upon need of dentally treated Soldier and recommended by licensed dentist, Contractor shall arrange for fulfillment of dental treatment for Soldier.

5.4.2.1.3 Contractor shall explain post-operatory instructions or verify that instructions were provided by treating Dentist to TXARNG treated Soldier and any Supervisor if necessary.