Q&A_Dental_Solicitation.pdf

QUESTIONS:

5.3 Continuation of Care. Contractor will perform post‐operative follow‐up (continuation of care) on all treatment, including, but not limited to, Root Canal treatments (RCTs) and extractions at Contractors cost. Contractor must have capability to prescribe medication in the state of Oklahoma through subcontracted local pharmacies. Follow‐ up care must be scheduled within fifty (50) miles of a Soldier’s home of record.

How are we to price the continuation of care? Are we to pad the pricing of equipment and supplies to cover this? A root canal can run $500‐1800 and surgical extractions with sedation can run $200‐2000. It is impossible to know who or how many will need continued care to budget for these events. Is there a way to add a CLIN for dental case management or continued care?

Item 5.4.2 is listed on both page 22 (concerning case management), and page 23 (concerning corporate and dental licensing). I’m asking that 5.4.2, page 23, eliminate the clause concerning the corporate entity. See attached explaining the law regarding this issue. We have fought and won this in several states. ARNG is beholden to AR 40‐68, and not individual State Dental Boards where corporate entities are concerned with regard to licensed professionals.

1. PWS at 5.1 Dental Exams still states “The contractor shall provide one price for a team…” yet that is not how Clin structure is at page 30.

Are you still looking for this type of pricing anywhere in the submission?

2. PWS at 5.2 Dental Treatment: same as above.

3. At Clin ITEM NO 0001, page 30, what does the 8 under Quantity signify?

4. Regarding 5.4.2 (pg 23): Please remove errant wording concerning Oklahoma corporate and dental licensing requirements (per yesterday’s email). Change phrasing to AR 40‐68, Section 4‐8, as that trumps all.

5. There are several duplicated paragraph numbers in Section 5 that pertain to different topics, particularly in the 5.4s.

6. Regarding 5.4.1 (pg 22) states, “15% of the alerted & eligible Soldiers will be classified as [DRC 3]. 15% of what number? The 2000 contracted exams or also the exams done by the government? What is the anticipated total treatment numbers (Soldiers) being contracted?

7. Please see other questions from yesterday’s email.

8. When do you anticipate the award to be announced?

ANSWERS

PWS:

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: The Government will provide space to some contracted operations and electric to most event locations. The Contractor will be informed if there are any issues with electricity and contractor will be required to supply needs to get operations completed.

3.1 Property: The Government will furnish some of the necessary workspace for the Contractor to perform services outlined in this PWS and pricing sheet. The Government will provide some equipment and or furniture based upon the location of the event. The contractor must be able will be required to provide all materials, supplies or equipment to perform operations and the government will inform Contractor if space will be provided for the operation.

5.1 Dental Exams. Contractor shall provide personnel to conduct dental exams, as listed on the ordering list in order to achieve the requested end state of each event. The Government will determine the number of needed personnel, via the ordering list, with the assistance of the contractor to meet the specific goal of each event. Each contracted position will provide services for a 10 hour perioddental exam teams as required by the task order. Each dental exam team shall be able to provide a minimum of 75 exams within a 10 hour period. The exam team shall provide all personnel, equipment, and exam materials necessary to fully complete each required treatment. The contractor shall provide one price for a team that included all of the aforementioned items. An estimated 2000 exams will be contracted annually. The majority of exams will take place from October through January.. See 5.4 and Appendix A for specific services to be provided.

5.2 Dental Treatment. Contractor shall provide personnel to conduct dental treatment based upon the requested end state of each event.

The Government will determine the number of needed personnel, via the ordering list, with the assistance of the contractor to meet the listed goals. Each contracted position will provide services for a 10 hour perioddental treatment teams as required by the task order.

Each dental treatment team shall be able to provide a minimum of 10 treatments within a 10 hour period. The treatment team shall provide all personnel, equipment, and treatment materials necessary to fully complete each required treatment. The contractor shall provide one price for a team that includes all of the aforementioned items. An estimated 750 treatments will be contracted annually.

The majority of treatment will take place from October through February within Oklahoma City. Some treatments will be conducted for exams that were completed my military dentists when treatment is the only contracted need. See 5.4 and Appendix A for specific services to be provided.

5.2.15.4.1. Based on past events, it is estimated that as a result of dental exams, 15% of the alerted & eligible Soldiers will be classified as Classification 3, Non-Deployable without Dental Treatment. This means that an estimated 15% of the population of Soldiers will require dental treatment to be raised to a Class 2 Status, or deployable, before their mobilization. The Contractor shall provide approved dental treatment only within an OSHA & ADA-Compliant Mobile Dental Practice at armories and training sites throughout the State when treatment plan is uploaded and approved in DENCLASS. After each dental examination is complete, the contractor shall make a decision based on the authorized dental treatment procedures listed below and convert as many Soldiers with a Dental Readiness Classification (DRC) 3 to DRC 2 or 1 in the event times outlined in Exhibit 3. Contractor shall attempt to convert as many DRC 3 during the event to provide a greatest number of medical ready Soldiers. Due to the complexity of some dental cases and the time required to convert certain cases, the contractor will prioritize Soldiers that will convert to DRC 2 within one hour over those that will take more than one hour to convert. Soldiers that require multiple days of treatment due to the complexity of their condition will only be seen by the contractor IF it does not delay the treatment of a Soldier that can be converted during the same day of the event.

5.35.4.2. Post event treatment. The contractor shall track the soldiers that are in need of post event treatment. The contractor shall obtain all necessary data from the soldier in order to schedule the post event treatment. For Soldiers that the contractor was unable to convert to DRC 2 or 1 due to either dental treatment complexity or time constraints due to an abnormal increased number of required treatments, the contractor will coordinate dental treatment at clinic within 25 miles of the Soldier’s HOR. If a clinic is not within 25 miles of the HOR or scheduling will not permit, the contractor will work with G1 Medical Branch to coordinate follow up care. The contractor will ensure that the clinic accepts United Concordia and will be required to utilize the Soldier’s Insurance, if they are insured through the Government Subsidized United Concordia plan. The government will pay any deductible or member portion but will not pay over the negotiated United Concordia price. If the Soldier does not have insurance, the government will pay the entire negotiated United Concordia price for the dental treatment required. The contactor will then update DenClass and convert the Soldier to either DRC 1 or 2 and bill the government the cost of treatment and an administrative fee for coordinating services and updating DenClass with the updated treatment records/ completion of the treatment plan.

5.3.15.4.3. The above listings are guides to assist the State Dental Officer or his/her designee in determining treatment to be authorized. The treatment provided by the ARNG is to get the Soldier from a dental class 3 to a dental class 2 only, Comprehensive Treatment (to DENCLASS I) is not authorized.

5.3.25.4.3.1. The contractor shall complete DENCLASS upload during the event. All Bitewings, Panograph X-rays, DD Form 603s, and any other documentation shall be completed during the event.

5.3.35.4.3.2. Additional dental notes/Common rating misconceptions:

1) Document wisdom teeth. Class 2 if asymptomatic. Class 3 if symptomatic. If a wisdom tooth is impacted and needs to be extracted it should be Class 3 and symptomatic.

2) Periodontal Screening and Recording PSR review. IF 3 associated with wisdom teeth clarify in notes.

3) Endodontic treatment only on restorable teeth.

4) Educate dentists about (PSR) classifications and treatment. Example: radiographic calculus, pocket depths, bleeding.

5) Full-mouth debridement (FMD) should coincide with PSR and radiographs. If 3’s in PSR FMD should be listed as Class 2 or 3 by dentist. If no 3’s in PSR, FMD is Class 1 or 2, and cannot be a Class 3. Soldier should be Class 2 FMD if 2’s in PSR, if one or two 3’s it is the treating dentists’ decision, but FMD needs to be in Treatment plan as Class 2 or 3.

6) Assistant is a quality control for dentist: FMD needed, wisdom teeth classification, filling classification, PSR, etc.

7) Ensure X-rays are uploaded in a timely manner.

8) If Wisdom teeth are symptomatic periodontally it should be reflected in the PSR as a 3 and clarified in the note section so a reviewing dentist can understand the classification of FMD. Example: 3 in PSR associated with symptomatic wisdom tooth or teeth.

5.3 Continuation of Care. Contractor will perform post-operative follow-up (continuation of care) on all treatment, including, but not limited to, Root Canal treatments (RCTs) and extractions at Contractors cost. Contractor must have capability to prescribe medication in the state of Oklahoma through subcontracted local pharmacies. Follow-up care must be scheduled within fifty (50) miles of a Soldier’s home of record.

5.4 General Requirements. The Contractor shall have working knowledge of Army Regulations 40-501, Standards of Medical Fitness, and 40-35, Dental Readiness & Community Oral Health Protection, and perform comprehensive oral evaluations, digital bitewings, and digital panoramic radiographs in accordance with said regulations, in a specific location which will be given at the time of notification by government of either 1, 2 or 3 above. The Contractor must use Health Insurance Portability and Accountability Act (HIPAA), & Occupational Safety and Health Administration (OSHA) Mobile Dental Practice or Portable Dental Equipment, when facilities and/or equipment are not provided by the Government.

The Contractor shall have experience in and capability to upload all exams and digital radiographs into the DENCLASS system. The Contractor shall ensure all Soldiers have a current Panoramic Radiograph on file, and if missing, the Contractor shall perform new radiographs. Contractor will have experience in and capability to upload radiographs into the Army Dental Digital Repository (ADDR) system (if needed). Soldiers without a current electronic Panoramic Radiograph in ADDR must have one. Contractor must confirm in ADDR. Contractor will take a new Panoramic Radiograph on all Soldiers after completion of treatment (when provided), and then upload into DENCLASS.

5.4.1 Contractor must create events in DENCLASS, listing all personnel supporting event, plus all OK ARNG Dentists and Dental Technicians. Contractor will secure an up-to-date list of OK ARNG Dentists and Dental Technicians from MEDCOM State Surgeon’s Office (SSO), prior to each event.

5.4.2 Adherence to all OSHA requirements, State and Federal Regulations is mandatory. The Contractor shall comply with all Oklahoma corporate and dental licensing requirements. The Contractor and dentists must provide proof that they are registered and authorized to provide dental services within the State of Oklahoma and is approved by the Oklahoma State Dental Board. Contractor Must Provide proof of its authorization through the Oklahoma Secretary of State as a corporate entity registered to provide dental services within the State of Oklahoma.

5.4.3 Contractor will practice OSHA compliant disposal of all hard tissue and/or medical waste.

5.4.4 A periodic oral evaluation (dental exam) shall assess the current state of oral health, risk for future dental disease, as well as assess general health factors that relate to the treatment of the patient. Dental exams will be conducted in accordance with standard clinical practice and (in accordance of AR 40-501). The following measures are required for each periodic oral evaluation (dental exam):

5.4.4.1 Blood pressure assessment – Screen Soldiers for hypertension, appropriately refer hypertensive patients to the state medical authority.

5.4.4.2 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 Army Dental Care System to identify those at high risk for future disease and appropriately manage their care.

5.4.4.3 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.

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

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

5.4.4.6 Radiographs should be taken only for clinical reasons according to Food and Drug Administration guidelines as determined by the patient’s dentist. Radiographs should be of diagnostic quality, properly identified and dated. A panograph must be present in each dental record and must be of adequate quality for diagnostic/identification purposes. There is no time requirement on updating pantographic radiographs. However, the pantographic radiograph must adequately represent the current oral condition of the Soldier.

5.4.5 Provide timely feedback on number and progress/status of dental examinations completed to the Office of the State Surgeon's designated representative within three (3) business days. Feedback should include any timelines or factors that may negatively impact processing of exams. The timeline will include the number of Soldiers completed and waiting to get services during the event. Also project the time each Soldier will need for services. This keeps other areas of operations (PHA) moving in positive direction for completion.

5.4.6 Contractor must notify the Office of the State Surgeon's designated representative at the end of each dental event. Provide identified military representative with the status of Soldiers completed or Soldiers that will need to return to complete dental services.

5.4.7 The Government (MEDCOM) will provide a full roster 14 days in advance of the event and a final roster 10 days before the event.

5.4.8 If there are any add-ons after the final Roster is given to contractor, the information needed to perform the event will be the responsibility of MEDCOM to provide dental records, dental information, and X-Rays (PANO). They will be uploaded into

DENCLASS.

5.55.7 Dental Services.

5.5.15.7.1 An undetermined number of each service listed in the PWS will be delivered throughout the period of performance, at multiple armories in the State of Oklahoma, with the possibility of simultaneous requirements, to be determined at the time the requirements are given to the contractor by the Government.

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Past Performance Questionnaire - See Exhibit/Attachment Table of Contents of the solicitation, Past Performance Questionnaire. For the contracts information identified by the offeror from information requested in (i) above, the offeror shall forward a copy of the Past Performance Questionnaire to the Points of Contact (POC) responsible for monitoring performance under such contracts.

Alternate POCs should be provided. The work performed as a subcontractor, or under a commercial contract will be accepted for evaluation. The POCs shall return the questionnaires directly to the contract specialist at kevin.p.brokish.mil@mail.mil kevin.p.brokish.civ@mail.mil not later than the offer due date shown in block 8 of the SF1449. The government shall not follow-up with Questionnaire points of contact to ensure timely submittal by the point of contact selected by the contractor. Any questionnaire not received by the date specified will not be reviewed or evaluated to support past performance confidence ratings. Any questionnaires not returned directly to the Contracting Specialist will not be reviewed and evaluated. Information contained in the questionnaires will be used to evaluate the offeror’s past performance.

FURTHER CLARIFICATION:

This is a mulit-year setup, more than one year in a period of performance.

This is not a multiple year with option periods.

This is an IDIQ in which we will order every 3 months.

Our money is only valid for one year at a time (hence annual appropriations) , which is not a problem on this multi-year contract because each quarter there will be a new order with a new obligation of funding.

What you are bidding on, with any ID type contract or BPA, is the frame work that will set the terms and conditions, period of performance, and pricing.

Notice that the period of performance on this IDIQ is two years (and some change) and we have a quantity of 8 (3 month) jobs that can be ordered over that period for a total of 2 years of coverage.