MEDCOM_PRP_-_PWS_PHA_2017.pdf

Performance Work Statement (PWS) for

Periodic Health Assessment/Soldier 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 in Paragraph 3.0 as Government Furnished, to perform Periodic Health Assessment/Soldier Readiness Services, as defined in this PWS.

1.1 Background. The Global War on Terrorism (GWOT) has significantly increased the operations and deployments within the Puerto Rico Army National Guard (PRARNG) and has placed additional strain and requirements on our Soldiers and their families.

Increased deployments and missions locally and around the globe have required Soldiers to be deployed more frequently, for longer periods in high physical and mental stress operations. Additional resources and programs are required to increase the PR-ARNG medical readiness. PRARNG leadership requires support to identify and quantify the magnitude and status of medical readiness across all Army National Guard units in the State of Puerto Rico

1.2 Period of Performance (PoP). The Period of Performance shall be one Year of 12 months; Performance will begin from April 1, 2017 through April 1, 2018

1.3 General Information.

1.3.1 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. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO) acceptance in writing of any proposed changes to its QCP.

1.3.2 Quality Assurance (QA). The Government shall 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 must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) (defect rate(s)).

PWS: Periodic Health Assessment/Soldier Readiness Services

1.3.3 Recognized Holidays: The following are recognized US holidays. The contractor shall perform services on these days:

1.3.3.1 New Year’s Day

1.3.3.2 Martin Luther King, Jr.’s Birthday

1.3.3.3 President’s Day

1.3.3.4 Memorial Day

1.3.3.5 Independence Day

1.3.3.6 Labor Day

1.3.3.7 Columbus Day

1.3.3.8 Veteran’s Day

1.3.3.9 Thanksgiving Day

1.3.3.10 Christmas Day

1.3.4 Place and Performance of Services. Hours of Operation: The contractor shall provide services between the hours of 0630-1830 on Monday through Sunday, except 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 at Camp Santiago Joint Maneuver Training Center (CSJMTC); Salinas, Puerto Rico. 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. Telecommuting is NOT authorized.

1.3.5 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.

1.3.6 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. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance.

1.3.7 Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the Contracting Officer’s Representative (COR). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. Should the Force

Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.3.8 COMSEC/IT Security. All communications with DOD organizations are subject to communications security (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 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.

1.3.9 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. This contract does not require use of Government Information systems.

1.3.10 Protection of Personally Identifiable Information (PII). The contractor shall protect all Personally Identifiable Information (PII) encountered in the performance of services in accordance with DFARS 224.103 and 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 who’s PII has been compromised.

1.3.11 AT Level 1 Awareness Training (AT). All contractor employees requiring access to Army Installations, facilities, and controlled access areas shall complete Level 1 AT within 10 calendar days after contract start date and within 10 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee, to the COR, or to the KO if a COR is not assigned, within 10 calendar days after completion of training. Level 1 AT is available at http://jko.jten.mil/courses/atl1/launch.html.

1.3.12 iWATCH Training. The contractor 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 will 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 10 calendar days of contract award and within 1 0 calendar days of new employees commencing performance. The contractor shall report completion for each affected contractor employee and subcontractor employee, to the COR, or to the KO if a COR is not assigned, within 10 calendar days after completion of training.

1.3.13 OPSEC Training. In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 10 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each affected contractor employee, to the COR, or to the KO if a COR is not assigned, within 10 calendar days after completion of training. Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.

1.3.14 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.

1.3.15 Key Control. This PWS does not require handling of keys.

1.4 Contractor shall provide all management, labor, test material and certification necessary to provide all listed services HIPAA, Privacy Act and OSAH Compliant.

1.5 Special Qualifications. The contractor shall ensure all employees possess all required licenses for operating heavy equipment, and any others, in the performance of this contract.

The Government does not provide training to contractors. The contractor shall provide qualified personnel, office material to perform the services, and /or OSHA, HIPPA, ADA, and Privacy Act Compliant services. Medical services will be performed by licensed medical/nursing/allied science professionals with oversight by the PRARNG, Office of the State Surgeon. Contractor shall be held liable and is responsible for ensuring and verifying the appropriate level of Credentialing / Privileging (Licensure, Diploma, Affiliation [Colegiación] Background checks, etc.) National Provider Data Base Query results for all contractive providers in support of any PRARNG event. Medical and Nursing Providers must be licensed in the state. The Contractor will provide a copy of all credentials and licenses of all personnel that will provide mentioned services. All contractors will be required to take yearly vaccination training IAW AR 40-563 and will provide copies to the COR of the Contract. The contractor shall obtain appropriate blood borne pathogen training in accordance with OSHA 1910.1030.

1.6 Post Award Conference/Periodic Progress Meetings. The contractor agrees to attend any post award conference convened by the KO in accordance with Federal Acquisition Regulations Subpart 42.5. The KO, Contracting Officer’s Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the Contacting Officer 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.

1.7 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 within 3 calendar days after contract award. 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, (or the KO if a COR is not assigned), 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.

1.8 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. The contractor shall retrieve all identification media (including vehicle passes) from their employees who depart employment for any reason. All identification media (i.e., badges and vehicle passes shall be returned to the COR within the 10 days of an employee’s departure).

1.9 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 any 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. Such actions may include, but are not limited to, removal from the contract, reduction in benefits, or termination of employment.

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.Contractor shall complete the following online training within 10 calendar days after contract award: Course number is N-US189-HB; available at: http://jko.jten.mil.

1.10 Contractor Travel: Not authorized on this PWS.

1.11 Data Rights: The Government has unlimited rights to all documents/material 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. Provide a copy 10 calendar days after contract completion. This right does not abrogate any other Government rights.

1.12 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 and in the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may affect 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.

2.0 Definitions and Acronyms.

2.1 Definitions.

2.1.1 CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or services 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'S REPRESENTATIVE (COR). An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment shall be in writing and shall 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 Performance Work Statement.

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 Key Personnel listed in 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 assure 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.

2.1.12 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.13 WORK WEEK. Monday through Friday, unless specified otherwise.

2.2 Acronyms

AAR After Action Report AC Area Commander AEI Army Enterprise Info Structure AFARS Army Federal Acquisition Regulation Supplement ANG Army National Guard AR Army Regulation ATCTS Army Training Certification Tracking System AUP Acceptable Use Policy BBP Better Business Practice CDM Concept Development Meeting CERFP CBRNE Enhanced Response Force Packages CBRN Chemical Biological Radiological Nuclear CCIRs Commander’s Critical Information Requirements CCE Contracting Center of Excellence CFR Code of Federal Regulations CM Contract Manager CNGB Chief National Guard Bureau COMSEC Communications Security CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf CPX Command Post Exercise CRTC Combat Readiness Training Center CST Civil Support Team CUI Controlled Unclassified Information DA Department of the Army DC Displaced Civilians DHS Department of Homeland Security DD250 Department of Defense Form 250 (Receiving Report)

DD254 Department of Defense Contract Security Requirement List DFARS Defense Federal Acquisition Regulation Supplement DMDC Defense Manpower Data Center DOD Department of Defense DSCA Domestic Support to Civil Authorities EMAC Emergency Management Assistance Compact EMI Emergency Management Initiative ENDEX End Exercise EXCON Exercise Control FAR Federal Acquisition Regulation FEMA Federal Emergency Management Agency FPCON Force Protection Condition FPM Final Planning Meeting FSRT Fatality Search & Recovery Team FTE Full Time Equivalent FTX Field Training Exercise HIPAA Health Insurance Portability and Accountability Act of 1996 HQDA Headquarter Department of Army HRF Homeland Response Force HSEEP Homeland Security Exercise & Evaluation Program IA Information Assurance IAPS Incident Action Planning Support IC Incident Commander ICS Incident Command System IMT Incident Management Team IPM Initial Planning Meeting IT Information Technology JELC Joint Event Life Cycle JET Joint Enabling Team JFHQ Joint Forces Headquarters JISCC Joint Incident Site Communications Capability JITEC Joint Interagency Training and Education Center JLLIS Joint Lessons Learned Information System JMETs Joint Mission Essential Tasks JOC Joint Operations Center JTR Joint Travel Regulation JTS Joint Training System JTF Joint Task Force JTIMS Joint Training Information Management System KO Contracting Officer LNO Liaison Officer MOA Memorandum of Agreement MPM Mid-Planning Meeting MSR Monthly Status Report NACI National Agency Check Inquires NGB National Guard Bureau NGRF National Guard Reaction Force

NIMS National Incident Management System NLT Not Later Than OCI Organizational Conflict of Interest OCONUS Outside Continental United States OCT Observer Controller Trainer ODC Other Direct Costs OPSEC Operations Security PCO Procuring Contracting Officer PII Protection of Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program SFE Special Focus Exercise SME Subject Matter Experts STARTEX Start Exercise TAR Travel Authorization Request TE Technical Exhibit TTX Table Top Exercise WWAF-RA Wide Area Workflow-Receipt and Acceptance

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 Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include desk space, telephones, and other items necessary to maintain an office environment.

3.2 Materials: None.

3.3 Equipment: The Government will provide the necessary equipment needed to complete services specified in this contract.

3.4 Services: None.

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.

5.0 Requirements.

5.1 The contractor shall provide all management, labor, material, equipment, certifications and supplies necessary to provide Medical: Blood Pressure, height and weight, and questionnaire screening, Periodic Health Assessments (PHAs), Specialty Physical Exams such as Chapter 3, ‘Over-40,’ Flight Physical Examination, etc, in accordance with AR (Army Regulations) 40-501, Immunizations required for IMR and theater specific compliance such as Hepatitis A/B, Influenza, Tetanus and Diphtheria, MMR, Polio, PPD, Varicella (vaccines to be supplied by ARNG), visual acuity and optometry exams. These actions are all necessary during both Periodic Health Assessments and as part of the Soldiers Readiness Process (SRP). Upon completion of services, medical information will be documented in accordance with Department of the Army Policy in Service Treatment Record (STR). The contractor shall also ensure the requirements of Occupational Safety and Health Administration (OSHA) and applicable Federal regulations are met. The contractor shall develop and maintain records that fully document serviced performed, examination results, and names of soldiers referred to medical/dental specialists. These records will be made available to the Puerto Rico State Surgeon/PR-Medical Command or Medical representative.

5.2 The Contracted Company will provide All Necessary Contractors to Complete Full

PHA and/or Physical Exam Requirements.

- Team Leader (Registered Nurse) Contractor: Shall have knowledge of all areas and be able to act as a liaison between the Medical Command administration and the working team. Special reporting to the State Surgeon/Deputy State Surgeon for case management post event.

Responsible for authentication of personnel attendance and submit an After Action Report (AAR).

- Provider (Physician) Contractor: Responsible for performing Periodic Health Assessment, review and all referrals. Will provide determination of returning soldiers to duty following an absence. Identify duty related injuries, accidents, illness and impairment. Order routine laboratories and x-rays when necessary.

Refers to Fort Buchanan RAHC, VA and other hospitals as necessary.

Complete all Electronic Medical Profiling in the E-Profile Module. Medically clears Soldier when proper medical evidence is provided by the Service Member. Provides information to soldiers on medical conditions that may limit the soldiers’ performance. All annotation and entry of services into the DD Form 2766- Adult Preventive and Chronic Care Flow sheet or appropriate document.

- Practical Nurse LPN Contractor: The Licensed Practical Nurse (LPN) contractor must have knowledge and skill to perform a variety of tasks specific to outpatient primary care. The LPN must have the knowledge and sufficient skill to understand nursing principles, practices and procedures; patient disease entities; ethics; interdisciplinary treatment/care plans; interpersonal and teaching skills; use of medical equipment, medical materials and supplies for the purpose of carrying out vital signs monitoring, referrals and identification of illness in patients whose age may range from 17 years to 60 years. Among their tasks are: Immunization, Vital Signs (BP, Pulse, Respiration), obtaining and recording height and weight measurements, EKG, and taking active part of the patient counseling and guidance in the process of PHA, SRP. All annotation and entry of services into the DD Form 2766- Adult Preventive and Chronic Care Flow sheet or appropriate document.

- Health Technician (Optometry Assistant) Contractor: The Contractor performs routine clinical procedures and tasks, to include patient history for review.

Measures visual acuity, distance and near, corrected and uncorrected vision.

Performs visual field evaluations using automated and manual visual field analyzers independently. All annotation and entry of services into the DD Form 2766- Adult Preventive and Chronic Care Flow sheet or appropriate document.

- Dental Assistant Contractor: Contractor functions in the areas of Oral

Dentistry, Radiology and Oral Diagnosis, receives soldiers for examination during evaluation events in the Dental Clinic. Prepares the evaluation area using proper infection control techniques as prescribed in service policies and by properly laying out all instruments and materials in the sequence of use and then prepares the soldier. Obtains and records information related to the medical and dental history of the patient including temperature, pulse and blood pressure. Charts information relayed by the Dental Provider. Will provide support to dental care provider at chair side. Passes instruments and materials to, and retrieves them from the dental provider, keeps the field maintains dental equipment and dental operatory in a clean and operable condition. Maintains and properly stores an adequate level of supplies.

Positions soldier and film for proper exposure of intra and extra-oral x-rays.

Processes exposed films, using either automatic or manual processing techniques. All annotation and entry of services into the DD Form 2766- Adult Preventive and Chronic Care Flow sheet or appropriate document.

- In processing/Out processing Support Contractor: Reviews referrals and refers more difficult requests to appropriate levels; receives telephone calls, relays messages to appropriate staff. Updates files for medical reports;

generates statistical report. All annotation and entry of services into the DD Form 2766- Adult Preventive and Chronic Care Flow sheet or appropriate document. Handles Medical Records, updates filling of same. Handles with the Service Member update of the electronic medical forms

5.3

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

5.5 Periodic Health Assessments and Physical Exams: the contractor shall conduct Periodic Health Assessments (PHA) and other physical exams (Over-40, Chapter 3, Flight, etc.) in accordance with the AR 40-501

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

5.7 Periodic Health Assessments (PHA) events: approximately 125 soldiers will be processed on every event day. This number can fluctuate according to the needs of the PRARNG. In the event of larger number of soldiers needing evaluation, the number of personnel assigned to the event will also vary. The unit will establish the need to prioritize rotation of key personnel. This event will flow as follows:

- 25 Soldier per team rotation

- Team rotation time will be hourly: 0730 / 0830 / 0930 / 1030…

Soldiers requiring fasting laboratory will report to the gazebo area by the lake at 0630Soldiers requiring fasting laboratory will report to the gazebo area by the lake at 0600. Onsite at Post- Event Case Management of Temporary and Permanent Profiles.

5.8 Soldier Readiness Processing (SRP) events: approximately 75 soldiers will be processed per day. The unit will establish the need to prioritizing rotation of key personnel.

This event will flow as follows:

- 25 Soldier per team rotation

- Team rotation time will be hourly: 0730 / 0830 / 0930

Soldiers requiring fasting laboratory will report to the gazebo area by the lake at 0630.

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

5.10 Reporting: The contractor shall provide a final report for all services provided to include a by name, unit, and social security number roster of all soldiers receiving services.

The report shall be approved and verified by the PRARNG liaison with the office of the Deputy State Surgeon of the PRARNG. The following data elements will be reported at the end of an event: Date, Location, List of contract employees, total number of patients’ scheduled, total number of patients examined.

5.11 Roster of participants will be provided by PRARNG prior to the event. The roster will be in excel format and will require the following information: Last, Name, First Name and Complete

SSN.

5.12 Licensed provider will identify, track, and provide clinical tracking of all PRARNG initiated Temporary and Permanent Profiles of PRARNG soldiers via hardcopy record/spreadsheet, as well as, the MND module in MODS.

5.13 When required, licensed provider will coordinate with Deputy State Surgeon and Health Services Section and arrange for fulfillment of required consultations and follow up.

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

5.14 The Contractor shall furnish the following documentation: Upon completion of services, medical information will be documented in accordance with Department of the Army Policy and be updated in the approved Army National Guard automated system. The contractor shall also ensure the requirements of Occupational Safety and Health Administration (OSHA) and applicable Federal regulations are met. The contractor shall develop and maintain records that fully document service performed, examination results, and names of soldiers referred to specialists. These records will be made available to the Puerto Rico State Surgeon/PR- Medical Command or Medical representative, NLT 5 days after initial request.

5.15 Contractor Manpower Reporting Application (CMRA).

5.15.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Puerto Rico National Guard, via a secure data collection site.

5.15.2 The contractor shall completely fill in all required data fields using the following web address: http://www.ecmra.mil/. Reporting inputs shall be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013. Contractors may direct questions to the help desk at http://www.ecmra.mil.

Technical Exhibit 1 Performance Requirements Summary

This Performance Requirements Summary includes performance standards applicable to this PWS The Government will use these standards to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

PWS Paragraph Task Performance Standard

Acceptable Quality Levels (AQL)

Surveillance Method / By Whom

5.1.2/5.1.2 Health Assessments and physical examination

Exams are performed in accordance with all regulations in

PWS

100% 98% Periodic Inspection - COR will review monthly work order logs.

5.1.4 Visual Acuity

Testing

Testing is performed in accordance with Army Regulation

100% 98% Periodic Inspection - COR will review monthly work order logs.

5.3 Management of

Profiles

Contractor will maintain files and follow-up on profiled soldiers

100% 98% Periodic Inspection - COR will review monthly work order logs.

5.2.3 Administrative

Functions

All reports and documents are submitted and input appropriately as defined

In-Out Processing

Report

100% 100% Periodic Inspection - COR will review monthly work order logs.

5.1.3 Electrocardiogram

Testing

Testing is performed in accordance with Army Regulation

100% 100% Periodic Inspection - COR will review monthly work order logs.

5.1 Immunization Administration of

Vaccine IAW

Regulation 40-

100% 100% Periodic Inspection - COR will review monthly work order logs.

5.14 T The

contractor shall develop and maintain records that fully document service performed, examination results, and names of soldiers referred to specialists.

The contractor shall make available the records to the Puerto Rico State

Surgeon/PR- Medical Command or Medical representative, NLT 5 days after initial request within the established timeframes 100% of the time each month.

0% failure to perform restorative maintenance within the established timeframes each month.

Periodic Inspection - COR will review monthly work order logs.

Technical Exhibit 2 Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of

Copies

Medium/Format Submit To

1.3.1 Quality Control

Plan

Provide within 10 calendar days after Contract Award

1 Electronic Submission

KO

1.3.11 AT Level 1

Awareness Training Certificates

Provide within 10 calendar days after contract award and new hiring

1 Electronic Submission

COR

1.3.12 WATCH

Training

Provide within 10 calendar days after Contract Award

1 Electronic Submission

COR

1.3.13 OPSEC Training

Certificates

Provide within 10 calendar days after Contract Award

1 Electronic Submission

COR

1.7 Contract Manager Provide within 3

calendar days after Contract Award

1 Electronic Submission

COR

1.8 Identification of

Contractor Personnel

Provide 10 days after contract completion.

1 Hard Copy

COR

1.9 Combatting of

trafficking of persons

Provide within 10 calendar days after Contract Award

1 Electronic Submission

COR

1.11 Data Rights

Provide 10 days after contract completion.

1 Hard and Digital Copies

COR