Vendors questions for OH Medical exams RFQ.docx

Industry question for OH Medical exams RFQ Question 1: Key personnel and physician role (PWS 5.1.2, 5.1.13, 5.2.1, 5.2.2). Our key provider will be a board-certified Occupational Medicine physician, supported by a physician assistant (PA), an RN, an LPN, a phlebotomist, and a medical assistant.

- (a) May the Occupational Medicine physician be a subcontractor or independent contractor to the prime, rather than a W-2 employee?

- (b) May the PA perform the physical exams (CLIN 0003) under the Occupational Medicine physician's supervision, with the physician signing the abnormal-result statements and respirator clearances?

- (c) Given PWS 1.4.1.1 ("Teleworking is not authorized"), must the physician be on site at each event, or may the physician review results, interpret PFTs, and sign clearances off site after the event?

Answer 1 (a): Yes, subcontractors may be used (2.1.8) provided they meet all the licensing and security requirements identified Answer 1 (b): DoDM 6055.05 defines an OM Provider-A licensed, qualified, and credentialed person who provides occupational medical services (e.g., physician, nurse practitioner, physician’s assistant).

Answer 1 (c): The government does not permit the contractor to telework in support of this mission per (must be onsite) 1.4.1.1

Question 2. Records and reporting (PWS 5.1.2, 5.1.3, 5.1.14; DFARS 252.204-7012).

- (a) Besides two hard copies, should results be delivered electronically? If so, in what format or system (for example, DD Form 2216 for audiograms or DOEHRS-HC)?

- (b) Are specific exam forms required?

- (c) Who keeps the original medical records, and for how long?

Answer 2 (a): No, we do not have a system for electronic copies Answer 2 (b): In MD, I provide the forms (which is specified in my PWS) but according to your PWS, para 4.1 reads: “contractor shall furnish everything required to perform these services” Answer 2 (c): VAARNG keeps the original and provides the copies to employees per our guidelines

Question 3. Medical liability insurance (PWS 5.1.4; Addendum to 52.212-1, item 3). What is the minimum per-claim and aggregate limits.

Answer 3: The PWS copy (dated Oct. 2022) reads medical liability Per 5.1.3 Medical Liability Insurance: Maintain medical liability insurance in a coverage amount acceptable to the Contracting Officer, which is not less than the amount usually prevailing within the local community for the medical specialty concerned. The Contractor is required to ensure that its subcontractors, if any, for provisions of health care services, contain the requirements of clause 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance. Indemnify the Government for any liability-producing act or omission by the Contractor, its employees, and agents occurring during contract performance. The contractor shall furnish to the COR prior to the contract award evidence of its insurability concerning the medical liability insurance required by this clause.

Question 4: Is a certificate of insurance (or a binder showing the coverage will be in force at award) acceptable as "proof of medical liability insurance" with the quote?

Answer 4: PWS states 5.1.3: “The contractor shall furnish to the COR prior to the contract award evidence of its insurability concerning the medical liability insurance required by this clause.” Yes, provided it meets the all of the requirements outlined in 5.1.3

Question 5: Are any other insurance types or limits required (general liability, automobile, workers' compensation)?

Answer 5: Contractors and their subcontractors, if any, must comply with 5.1.3 Medical Liability Insurance and all physical and communications/information technology security requirements specified in the PWS.

Question 6: Staffing per event (PWS 1.4.1, 5.2; Section L 1.B.1). Does the Government expect a minimum number of personnel or exam stations (for example, number of audiometric booths) per event?

Answer 6: PWS states 1.4.1 …The contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined with this PWS. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the workforce is essential. Teleworking is not authorized. Answer is no, as a PWS is set up for the vendor to tell us how they plan on doing it to a certain degree.

Question 7: Is there an expected daily throughput (employees per day) we should plan to?

Answer 7: See Question 6 and the answer, which will answer this one.

Question 8: Audiometric equipment (PWS 5.1.14). Is there a required audiometer make or model (for example, one compatible with DOEHRS-HC, such as the Benson CCA-200)? Or is any calibrated audiometer that meets ANSI S3.6, with results recorded on DD Form 2216, acceptable?

Answer 8: As long as the monitoring equipment meets DA PAM 40-501, 3-6 standards. DD2216 for annual surveillance form, DD2215 for Baseline

Question 9: May the audiometer be rented for each event, provided calibration certificates are current?

Answer 9: Yes, as long as they meet the DA PAM 40-50, 3-6 approved equipment

Question 10: Approximately what percentage of employees require lead/ZPP, cadmium, or chromium testing each year?

Answer 10: 5% There are approximately 600 people in the program.

Question 11: Is the contractor expected to provide the same clinical personnel at all Virginia locations, or may appropriately credentialed personnel be assigned regionally to the various performance locations?

Answer 11: Yes, clinical personnel may differ based on the site as long as they meet criteria in PWS, however, 1.4.1 …When hiring personnel, the contractor shall keep in mind that the stability and continuity of the workforce is essential.

Question 12: Would the Government consider a delivery model in which the prime contractor maintains centralized program management and quality assurance while deploying qualified regional clinical teams to the individual Virginia locations?

Answer 12: Hiring of staff are at the contractor’s discretion, provided that all licensing requirements and safety and security requirements are met. Personnel may differ based on the site as long as they meet criteria in PWS, however, 1.4.1 …When hiring personnel, the contractor shall keep in mind that the stability and continuity of the workforce is essential.

Question 13: Clinical Staffing: Does the Government permit qualified personnel to perform multiple functions, such as a medical technician certified in both pulmonary function testing and audiometry, provided all PWS qualifications and performance standards are met?

Answer 13: Yes, provided all PWS qualifications and performance standards are met Question 14: Event Duration: What is the anticipated number of operating hours per service day, and are multi-day events generally scheduled at consecutive locations to minimize repeated mobilization costs?

Answer 14: Throughput depends on how many employees they are able to see per day with the staff they provide to fulfill the requirements. Typically, services will be provided between the hours of 0730-1630. Efforts will be made to schedule consecutive locations to minimize repeated mobilization costs Question 15: Is the contractor required to maintain separate medical/testing equipment at each of the six locations, or may the same mobile unit and equipment travel between locations as events are scheduled?

Answer 15: Mobile unit may travel as long as any relevant calibrations are completed at each site Question 16: For events involving multiple service locations, the PWS states that only one location will be scheduled per day and locations will be scheduled in successive order. Does this mean all required locations for a particular event are generally expected to be completed on consecutive days/within the same week, or may they be scheduled over a longer period?

Answer 16: Efforts will be made to schedule consecutive locations to minimize repeated mobilization costs Question 17: Since this is a single award blanket purchase agreement should I assume that you are looking for an “each” price or a quantity of 1 for each Clin? Then as quantities are determined for each location that “each” price would be multiplied by the quantities needed per location.

Answer 17: Yes, we are looking for a price for each CLIN. Then when a call order is issued the quantities will be on the released call order for each location.

Question 18: Should pricing be created for each of the five years of the BPA?

Answer 18: Yes, please price for all five years. Also, at the start of any new fiscal year BPA holder may submit updated pricing for the new period.

Question 19. The solicitation requires proof of medical liability insurance with the quote. If the prime contractor will perform the exams through a qualified medical subcontractor, will the Government accept the subcontractor's medical professional liability policy as meeting this requirement? If so, are there minimum coverage limits, and must the prime be named as an additional insured?

Answer 19: You as the prime contractor shall send proof of medical liability insurance with the quote. For your subcontractors you shall insert clause 52.237-7 including paragraph (f) in all subcontracts for health care services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At five days before the commencement of work by any subcontractor, the Contractor shall furnish the Contracting Officer evidence of such insurance. The amount should not be less than the amount usually prevailing within the local community for the medical specialty concerned.

Question 20: Can you please give expected number of events per year, the expected number of employees examined per year, per site, and historical counts for physical exams, audiograms, pulmonary function tests, vision exams and each lab line.

Answer 21: The first call orders may be at least 82 employees at one site. The other call orders may be 12 to 18 employees and usually not more than two sites for that year. However, these are unknown factors at this time.

Question 22: The Statement of Work requires hearing screenings (audiograms), but the price schedule has no line item for them. Should audiogram costs be included in the per-exam price, or will a separate line item be added by amendment?

Answer 22: The audiogram should be included in the Physical exam CLIN.

Question 23: Mobile clinic (PWS 5.1.1, 3.1; Section L 1.B.2; CLIN 0001). PWS 5.1.1 requires a "fully equipped mobile clinic." Section L says the Government will furnish workspace at each location. Is a mobile medical vehicle required at every location? Or may the contractor set up portable, calibrated equipment (including a portable audiometric booth) in Government-furnished space? What should CLIN 0001 cover?

Answer 23: Section L has been removed as the Government will not furnish workspace.

Question 24: Limitations on subcontracting. Section I doesn't list FAR 52.219-14, and the BPA ceiling is $350,000. Please confirm whether FAR 52.219-14 (Limitations on Subcontracting) applies to this BPA or its call orders. Also, the SF 1449 states that FAR 52.212-5 is attached. Could you provide the completed 52.212-5 checklist?

Answer 24: Yes, the limitation on subcontracting applies to agreement and call orders.

Question 25: . Wage determinations (Attachment 0002). The package includes WDs 2015-4323, 2015-4313, and 2015-4341. It doesn't include one covering Troutville (Botetourt County) or Gate City (Scott County). Will WDs for those locations be added? Also, which WD occupation should be used for CAOHC-certified audiometric technicians and NIOSH-certified spirometry technicians, which aren't listed?

Answer 25: An updated Wage determination has been added. The information listed in 52.222-42 are employees expected to be employed under the contract and states the wages and fringe benefits payable to each if they were employed by the contracting agency subject to the provisions of 5 U.S.C 5341 or 5332. This is not a wage determination.

Question 26: Travel (PWS 1.4.12; CLIN 0002). PWS 1.4.12 authorizes travel expenses consistent with the JTR, with COR/KO approval. Should travel (mileage, lodging, per diem) be billed at actual cost under the JTR on each call order? Or should it be included in the fixed unit price for CLIN 0002? If it's included, is CLIN 0002 priced per event, per location-day, or per person?

Answer 26: Travel expense should be included in CLIN 0002 per call order, per event. All travel requires COR recommendation for approval and/or authorization by the Contracting Officer prior to travel arrangements being made.

Question 26: - (a) Since the maximum order is $25,000, will a multi-location event be split across several call orders?.

- (b) Please confirm the full addresses and ZIP codes for 700 Portugee Rd, Sandston (listed with ZIP 23824), and for 3777 E Virginia Beach Blvd (listed as Virginia Beach 23452).

Answer 26 (a): If there more than one location needs medical exams separate call orders will be issued for that location Answer 26 (b) 700 Portugee Road Sandston VA 23150, 3777 E Virginia Beach Blvd VA 23529 Question 27. Quote content and vision exams (Section M; PWS 5.1.12; Technical Exhibit 1). (a) Besides the four listed items (Information Sheet, 52.219-1, proof of insurance, Pricing Schedule) and the signed SF 1449, should quoters include a capability statement, key-personnel credentials, equipment calibration records, or past-performance references?

Answer 27: No, you don’t have to provide personnel credentials, equipment calibration records.

Question 28: Will exam records be considered Controlled Unclassified Information requiring NIST SP 800-171 compliance and a current SPRS score under DFARS 252.204-7012? If so, will that requirement flow down to subcontractors who maintain the medical records?

Answer 29: Yes the exam records will be considered CUI. Subcontracts. The Contractor shall clause 252.204-7012 including this paragraph (m), in subcontracts, or similar contractual instruments, for operationally critical support, or for which subcontract performance will involve covered defense information, including subcontracts for commercial products or commercial services, without alteration, except to identify the parties. The Contractor shall determine if the information required for subcontractor performance retains its identity as covered defense information and will require protection under this clause, and, if necessary, consult with the Contracting Officer; and (2) Require subcontractors to— (i) Notify the prime Contractor (or next higher-tier subcontractor) when submitting a request to vary from a NIST SP 800-171 security requirement to the Contracting Officer, in accordance with paragraph (b)(2)(ii)(B) of this clause; and (ii) Provide the incident report number, automatically assigned by DoD, to the prime Contractor (or next higher-tier subcontractor) as soon as practicable, when reporting a cyber incident to DoD as required in paragraph (c) of this clause.

Question 30: May the prime contractor utilize qualified subcontractors to perform portions of the required occupational health services, including onsite medical examinations, audiometry, pulmonary function testing, phlebotomy, and laboratory services?

Answer 30: Yes, subcontractors may be used (2.1.8) provided they meet all the licensing and security requirements identified Question 31: If subcontractors are permitted, may the prime contractor coordinate services through qualified Virginia-based clinical personnel and occupational health partners while retaining responsibility for contract administration, scheduling, quality assurance, reporting, and overall contract performance?

Answer 31: While you are permitted to use subcontractors the legal, regulatory, and final operational responsibility for administering the prime contract remains with the prime contractor.

Question 32: Are there specific limitations on the percentage or type of work that may be subcontracted under this small-business set-aside beyond the applicable FAR requirements and clauses contained in the solicitation?

Answer 32: 13 CFR 121.103 For service contracts: If a subcontractor is performing the “primary and vital” parts of the contract, or if the prime is “unusually reliant” on them, the SBA treats them as a single entity.

Question 33: For specialized personnel requirements, such as occupational medicine/pulmonary function and audiometric testing, may these requirements be satisfied through appropriately qualified subcontracted personnel?

Answer 34: Yes, provided all PWS qualifications and performance standards are met Question 35: May required laboratory testing be performed through a subcontracted licensed laboratory, provided the laboratory meets all requirements identified in the solicitation?

Answer 36: Yes provided the laboratory meets all of PWS qualifications Question 37:CLIN 0001 – Mobile Unit Setup Fee: Is this fee payable once per event, per service location/day, or per call order, particularly when an event includes multiple locations on successive days?

Answer 37: Per call order and per location. So, if issued two call orders at different locations the cost for mobile unit setup fee would be on both call orders Question 38: CLIN 0012 – Master Summary Report: Is this CLIN payable once per event, per service location, or per call order?

Answer 38: Per call order.

Question 39: Cancellation and Rescheduling: What notice will the Government provide when an event is canceled, postponed, or reduced in scope? Is compensation available for nonrefundable travel expenses or committed clinical personnel?

Answer 39: If a released call order was sent out to vendor, a modification will be issued for any changes and cancellation. The amount of days/time need for the vendor not to incur cost will be in the released BPA.

Question 40: Is there an incumbent vendor?

Answer 40: The last vendor that was awarded the OH Medical contract was Apple Occupational Medical Services LLC with total cost to include base and options was $42,780.00.