PWS_-_Future_AMRE_Contract.doc

PERFORMANCE WORK STATEMENT (PWS)

FOR PROVIDING ANNUAL MEDICAL AND DENTAL SCREENINGS TO INCLUDE DENTAL TREATMENT OF DENTAL CLASS III CONDITIONS

PART 1

GENERAL INFORMATION

1. GENERAL INFORMATION:

1. General: This is a non-personnel services contract to provide annual medical, hearing, immunization, and dental readiness services. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1 Description of Services/Introduction: The Contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform annual medical, hearing, immunization, and dental readiness services as defined in this Performance Work Statement except for those items specified as Government furnished property and services. The Contractor shall perform to the standards in this contract.

1.2 Background: Individual Medical Readiness (IMR) and Fully Medically Ready (FMR) are the basic principles of force-sustainment for Army National Guard (ARNG) forces. Medical and Dental health is vital for force health protection, and failure to achieve a standard of level of medical and dental health could preclude a Soldier from deploying. Medical and Dental Readiness is a command responsibility. The purpose of this PWS is to cover the various components of IMR/FMR, to include, but not be limited to: Medical: Blood Pressure, height & weight, and questionnaire screening, Periodic Health Assessments (PHAs); Specialty Physical Exams such as Chapter 2 (schools), 'Over-40,' Flight, etc., in accordance with AR (Army Regulations) 40-501 (Standards of Medical Fitness); laboratory / phlebotomy work such as sample collection for HIV testing, urine pregnancy testing, pap-smear evaluation, DNA testing, G6PD, Titer, and RPR testing; Immunizations required for IMR/FMR and theater specific compliance such as Hepatitis A/B, Influenza, PPD (in some cases, vaccines will be supplied by ARNG), visual acuity and Optometry exams, DOEHRS direct computer upload compatible audiometry exams, comprehensive audio evaluations, and SPRINT testing, MEDPROS entry of all applicable and appropriate IMR/FMR functions including completion of the electronic PHA in the MEDPROS online module during an event by providers trained in completing the e-PHA online, and Post Deployment Health Reassessments (PDHRA). Dental: annual dental exams, digital bitewings radiographs, digital panoramic radiographs, DENCLASS data entry of all radiographs and dental records, identification and treatment of all Class 3 Soldiers who are able to be treated in a remote treatment setting and are not projected to require follow up dental treatment procedures.

1.3 Objectives: The purpose is to convert all Soldiers due or identified a needing annual medical, hearing, immunization, and dental readiness services at an event to a medical readiness class of 1 or 2.

1.4 Scope: The objective of this contract is to conduct and complete the requirements of ARNG IMR/FMR medical, hearing, immunization, and dental readiness requirements on all eligible (mobilizing or not) Service Members (SMs) in the ARNG utilizing HIPAA, ADA and OSHA-Compliant contractor set up in Missouri National Guard Facilities or mobile health facilities (if mobile facilities are determined to be needed). Medical and dental services shall be performed by Missouri licensed professionals. The contractor shall be held liable and are responsible for ensuring and verifying the appropriate level of Credentialing /Privileging (Licensure, Diploma, background checks, etc.) for all contract providers in support of any ARNG.

1.5 General Information

1.5.1 Quality Control: The Contractor shall develop and maintain an effective quality control program 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 quality control program is the means by which he assures himself that his work complies with the requirement of the contract. After acceptance of the quality control plan the Contractor shall receive the contracting officer’s acceptance in writing of any proposed change to his QC system.

1.5.2 Quality Assurance: The Government shall evaluate the Contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. 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 the minimum acceptable defect rate(s).

1.5.3 Hours of Operation: The Contractor is responsible for providing services, between the hours specified in Technical Exhibit 3. The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.5.4 Place of Performance: The work to be performed under this contract will be performed at government facility (see Technical Exhibit 3).

1.5.5 Security Requirements: Contractors performing work under this contract must maintain a list of all personnel performing services at event for access on government and military facilities.

1.5.6 AT/OPSEC: Contractors require level I OPSEC training and know the MONG Critical Information List (CIL) IAW AR 530-1. Applicability statement: Contractors must comply with contractually imposed operations security requirements. Also, if contractors have access to government information they are required to follow the same requirements for protection of sensitive, unclassified government information per Joint Ethics Regulation and Public Law. Contracts that Require OPSEC Training. Per AR 530-1, Operations Security, new contractor employees must complete Level I OPSEC training within 30 calendar days of their reporting for duty. All contractor employees must complete annual OPSEC awareness training.

1.5.7 AT Level 1 Awareness Training (AT): 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.

1.5.8 AT Level I Training. All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 30 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: https://atlevel1.dtic.mil/at.

1.5.9 iWATCH Training. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). 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. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance with the results reported to the COR NLT 5 calendar days after contract award.

1.5.10 Pre‐screen candidates using E‐Verify Program. The Contractor must pre‐screen Candidates using the E‐Verify Program (http://www.dhs.gov/E‐Verify) website to meet the established employment eligibility requirements. The vendor must ensure that the candidate has two valid forms of Government issued identification prior to entering the correct information into the E‐Verify system. An initial list of verified/eligible candidates must be provided to the COR no later than 3 business days after the initial contract award.When contracts are with individuals, the individuals will be required to complete a Form I‐9, Employment Eligibility Verification, with the designated Government representative. This Form will be provided to the Contracting Officer and shall become part of the official contract file.

1.5.11. Physical Security: The Contractor shall be responsible for safeguarding all Government information for Contractor use. At the close of each work period, Government facilities, equipment, and materials shall be secured. Contractor will be responsible for security of equipment and material uses to complete the PWS.

1.5.12. Special Qualifications: HIPAA Training, MILVAX certified, access MEDPROS and MEDCHART databases.

1.5.13. Post Award Conference/Periodic Progress Meetings: The Contractor shall attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor's performance. At these meetings the contracting officer will apprise the Contractor of how the Government views the Contractor's performance and the Contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the Government.

1.5.14. Key Personnel: The follow personnel are considered key personnel by the Government:

1.5.14.1. Contract Manager: The Contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the Contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between the dates/times specified in Technical Exhibit 3.

1.5.14.2. Physician (General and Family Practice): years of experience in specialty: minimum 1 year practice experience, minimum education: Possess MD or DO from accredited school, certification/license: active unrestricted state medical license, ACLS: preferred, and BCLS: preferred

1.5.14.3. Optometrist: years of experience in specialty: minimum 1 year practice experience, minimum education: Possess OD from accredited school, certification/license: active/unrestricted state licensure required, ACLS: preferred, and BCLS: preferred.

1.5.14.4. Audiologist: years of experience in specialty: minimum 1 year practice experience, minimum education: possess MA or AuD from accredited school certification/license: active/unrestricted state licensure required, ACLS: preferred, and BCLS: preferred.

1.5.14.5. Physician’s Assistant: Years of Experience in Specialty: minimum 1 year experience, minimum education: master’s level degree and accredited PA program, certification/license: licensure required for state employment, BCLS: preferred

1.5.14.6. Behavioral Health Counselor: years of experience in specialty: minimum 1 year experience, minimum education: master’s level degree, certification/license: licensure required for state employment, BCLS: preferred

1.5.14.7. Nurse Practitioner: Years of Experience in Specialty: minimum 1 year experience, minimum education: MSN or Advanced Certification, certification/license: required for state employment, ACLS: preferred, BCLS: required for state employment.

1.5.14.8. Registered Nurse: general years of experience in specialty: minimum 1 year experience, minimum education: RN-AD or diploma, BSN preferred, certification/license: certification preferred, licensed required for state employment, ACLS:

preferred, BCLS: required for state employment.

1.5.14.9. Medical Assistant (Certified/Registered): years of experience in specialty: minimum 1 year experience, minimum education: state license and graduate of accredited MA program, certification/license: required/required

1.5.14.10. Hearing Conservationist: years of experience in specialty: minimum 1 year experience, minimum education: DOEHRS Certified, certification: required,

1.5.14.11. Optometry Technician: years of experience in specialty: NA, minimum education: High School Diploma

1.5.9. Identification of Contractor Employees: All contract 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 in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by Contractors are suitably marked as Contractor products or that Contractor participation is appropriately disclosed

PART 2

DEFINITIONS & ACRONYMS

2. 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. 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 appointed by the contracting officer to administer the contract. 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, but may include 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 privities 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.

2.2. ACRONYMS:

ADCS

Army Dental Care System

ADA

American Dental Association

ADDR

Active Duty Dental Repository

ALARACTS

All Army Activities

ACOR

Alternate Contracting Officer's Representative

AFARS

Army Federal Acquisition Regulation Supplement

AR

Army Regulation

ARNG

Army National Guard

CAC

Common Access Card

CLIA

Clinical Laboratory Improvement Amendments

CCE

Contracting Center of Excellence

CFR

Code of Federal Regulations

CONUS

Continental United States (excludes Alaska and Hawaii)

COR

Contracting Officer Representative

COTR

Contracting Officer's Technical Representative

COTS

Commercial-Off-the-Shelf

DA

Department of the Army

DD250

Department of Defense Form 250 (Receiving Report)

DD254

Department of Defense Contract Security Requirement List

DENCLASS

Dental Classification Application

DENCOM

Dental Command

DFARS

Defense Federal Acquisition Regulation Supplement

DMDC

Defense Manpower Data Center

DOD

Department of Defense

DNA

Deoxyribonucleic Acid

DOEHRS

Defense Occupations and Environmental Health Readiness System

DRC

Dental Readiness Classification

DRE

Digital Rectal Exam

DTR

Dental Treatment Record

FAR

Federal Acquisition Regulation

FMR

Fully Medically Ready

G6PD

Glucose - 6 - Phosphate Dehydrogenate

HCG

Human Chorionic Gonadotropin

HIPAA

Health Insurance Portability and Accountability Act of 1996

HIV

Human Immunodeficiency Virus

HRR

Health Readiness Record

IAW

In Accordance With

IMR

Individual Medical Readiness

ISO

Isolation

KO

Contracting Officer

MEB

Medical Evaluation Board

MEDCOM

U.S. Army Medical Command

MEDCHART

Medical Electronic Data (for) Care History and Readiness Tracking

MEDPROS

Medical Protection System

MMRB

Medical MOS Retention Board

MND

Medical Non-deployment Module

MWDE

MEDPROS Wed Data Entry

MODS

Medical Operational Data System

MOS

Military Occupational Specialty

MRC

Medical Readiness Classification

NGB

National Guard Bureau

OCI

Organizational Conflict of Interest

OCONUS

Outside Continental United States (includes Alaska and Hawaii)

ODC

Other Direct Costs

OSArS

Office of the State Army Surgeon

OSHA

Occupational Safety and Health Administration

PDHRA

Post Deployment Health Reassessment

PEB

Physical Evaluation Board

PHA

Periodic Health Assessment

PIPO

Phase In/Phase Out

POC

Point of Contact

PPD

Tuberculosis/Tuberculin Skin Test

PPE

Personal Protective Equipment

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

RDA

Registered Dental Assistant

RPR

Rapid Plasma Reagin

SPRINT

Speech in Noise Recognition Test

SRC

Soldier Readiness Check

SRP

Soldier Readiness Processing

STR

Soldier Treatment Record

SOW

Statement of Work

TE

Technical Exhibit

TITMUS

Vision Testing Equipment Manufacturer’s Name

TMC

Troop Medical Clinic

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: The Government will provide a pre-event point of contact to coordinate services, an on-site POC to coordinate entry to the facility and assist with providing access to government, provided tables, chairs, and spaces to be used when applicable. The government will provide a Soldier with access to the DOEHRS-DR to download event data one day prior to set-up and upload data to the DOEHRS-DR one day after the event.

3.2. Facilities: The Government will provide adequate work space for the contactor to complete all requirements in the time designated. A government representative will be designated to provide the contractor access and to secure the facility at the conclusion of each day.

3.3. Utilities: Unless mobile facilities are required, the Government will make available all utilities in the facility for the Contractor’s use in performance of tasks outlined in this PWS. If utilities are furnished, the following is required, the Contractor shall instruct employees in utilities conservation practices. The Contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning vehicles and equipment.

3.4. Equipment: The Government will not provide equipment.

3.5. Materials: The government will supply routine adult immunization and packaging and shipping materials for HIV testing.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

4.2. Materials. The Contractor shall furnish medical and dental service materials and supplies necessary to meet the requirements under this PWS.

4.3. Equipment .The Contractor shall furnish medical and dental equipment to provide the services to meet the requirements under this PWS. Contractor will provide laptops with DOEHRS software loaded. Contractor will also provide computer kiosks with CAC card readers and internet access for Soldiers to complete ePHA screening through MEDPROS.

PART 5

SPECIFIC TASKS & REQUIREMENTS

5. SPECIFIC TASKS & REQUIREMENTS:

5.1. Basic Services. The Contractor shall provide services for Individual Medical Readiness IAW with AR 40-501 and DoDI 6025.19.

5.2. Medical Services.

5.2.1. Periodic Health Assessments (PHA): The contractor shall conduct PHAs in accordance with the PHA guidance set forth by AR 40-501 (23 04August 2010 2011RAR). Contractors must have the ability to complete the e-PHA on site via the e-PHA in the applicable MEDPROs module during the event. The contractor must utilize either OSHA-Compliant Mobile Health Practices and/or sites determined by the ARNG. Compliance with OSHA, State & Federal Regulations is mandatory.

5.2.2. Post Deployment Health Re-Assessments (PDHRA): the contractor shall conduct PDHRAs in accordance with AR 40-501 (RAR 003, 08/04/2011). The contractor must utilize either an OSHA & ADA Compliant Mobile Health Practice and/or sites determined by the ARNG. Compliance with OSHA, State & Federal Regulations is mandatory.

5.2.3. Periodic Health Assessments and Physical Exams: the contractor shall conduct Periodic Health Assessments (PHA) and other physical exams (Over-40, Chapter 2, Flight, etc.) in accordance with AR 40-501 (RAR 003, 08/04/2011). The contractor shall conduct physicals in an HIPAA, Privacy Act and/or OSHA Compliant facility to include visual acuity (Snellan/near vision), ANCI certified and DOEHRS compatible audiometer, on-site laboratory testing for lipids, glucose, urinalysis, HCG, titer and hemoglobin, a complete physical exam by certified clinician, tonometry, and vital signs, and e-PHA, DOEHRS, and HRR input. All professionals shall be licensed and adhere to all requirements of OSHA, State & Federal Regulations is mandatory. Contractor will provide computer kiosks with internet access and CAC card readers in order to have Soldiers complete the online ePHA through MEDPROS, the number of kiosk will be based on the total projected number of Soldiers to be screened and the workflow to meet the above requirements. The contractor will screen all rosters prior to the event. Any counseling conducted during the PHA provider interview will be documented on the electronic PHA survey and on Government provided forms such as a SF 600.

5.2.4. Profiles: No permanent profiles will be issues by contractor. Contractor shall initiate temporary profiles lasting 90 days or less for conditions disclosed to the contractor when service members provide medical documentation to substantiate the medical condition. The exception to issuing a temporary profile in the absence of medical documentation pertains to moderate to severe behavioral health concerns. All other medical concerns will be annotated on an SF 600 and provided to event POC for further action. A roster of total profiles initiated will be provided to the event POC/Commander.

5.2.5. Visual Acuity Testing (Snellan/near vision): The contractor shall conduct visual acuity testing in accordance with AR 40-501 (RAR 003, 08/04/2011). Adherence to OSHA, State & Federal Regulations is mandatory.

5.2.6.. All audiology exams must be provided in a Mobile Audiology Practice with a minimum of 8 audiometers and one isolation booth for SPRINT. DOEHRS Compatible Audiometer Testing: Portable audiometer testing is not acceptable, audiometer testing must be provided in a mobile facility IAW paragraph 3-6, DA Pam 40-501. The contractor shall conduct audiometry in accordance with AR 40-501 (RAR 003, 08/04/2011). Audiology Test Booth Certification forms must be posted in the Mobile Audiology Practice IAW paragraph 3-6c DA Pam 40-501. Audiometer must be DOEHRS real time upload compatible. The contractor must provide a DOEHRS certified technician with a valid certificate issued by the Army Hearing Program, along with laptops with DOEHRS software. Adherence to all requirements of OSHA, State & Federal Regulations is mandatory. Audiology evaluations and Speech Recognition in Noise Test (SPRINT) testing will be performed IAW all applicable Federal, DOD, MEDCOM, NGB, and State guidelines. SPRINT testing must be available at all events when requested and the results must be available immediately.

5.2.7. Immunizations: The contractor shall conduct immunizations in accordance with AR 40-501 (RAR 003, 08/04/2011). Immunizations shall include, but not be limited to Anthrax, Smallpox, Influenza (various), yellow fever, typhoid, tetanus (TDAP), tuberculosis (TB) skin test, meningococcal, hepatitis A, hepatitis B, and polio. Contractor shall be MILVAX certified as well as will adhere to all requirements of the OSHA and State & Federal Regulations.

5.2.8. Phlebotomy/Lab: the contractor shall conduct all laboratory / phlebotomy services such as HIV, Titer , G6PD blood draws, pregnancy testing, and lipid profiles, as well as flight physical or special forces unique blood draws IAW AR 40-501 (RAR 003, 08/04/2011). All HIV specimens will be turned over to the Laboratory that is currently under contract with the ARNG or NGB for testing. The contractor shall utilize the current accepted shipping method and supplies proved by the Center of Disease Detection (CDD) to the National Guard.

5.2.9. DNA Collection: The contractor shall conduct DNA collection in accordance with the AR 40-501 (RAR 003, 08/04). The contract will utilize the ARNG Medical Detachment for all DNA supplies, shipping supplies, and shipping guidance. Adherence to all requirements of OSHA, State & Federal Regulations is mandatory.

5.3. Dental Examinations

5.3.1. 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 IAW AR 40-501 (RAR 003, 08/04/2011) The contractor must use HIPAA, OSHA & ADA Compliant Mobile Dental Practice or Portable Dental equipment. The contractor shall have experience in and capability to upload all exam and digital radiographs into the DENCLASS system on-site. The contractor shall ensure all Soldiers have a current digital Panoramic Radiograph on file and if missing, the contractor shall perform new radiographs. Adherence to all OSHA requirements, State and Federal Regulations are mandatory. Film or 'digitized' radiographs will not be accepted.

5.3.2. Diagnostic Services:

· DOl20-Periodic Oral Evaluation

· DOl50-Comprehensive Oral Evaluation

· D0330-Panorarnic Film

· D0272-Bitewings-Two Films

· D0274-Bitewings-Four Films

· D02201D0230- Periapical (limited)

5.3.3. Exam. A periodic oral evaluation shall assess the current state of oral health and risk for future dental disease, as well as assessing general health factors that relate to the treatment of the patient. The following measures are required for each periodic oral evaluation:

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

5.3.3. 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.

5.3.3. 3. Tobacco risk assessment - Classify Soldiers as a smoker, user of smokeless tobacco or as both.

5.3.3. 4. Oral cancer screening - Perform a thorough oral cancer screening on all beneficiaries as part of all annual examinations.

5.3.3. 5. Digital radiographs should be taken only for clinical reasons according to FDA guidelines as determined by the patient's dentist. Radiographs should be of diagnostic quality, properly identified and dated. A digital panograph is required to be present in dental record and it must be of adequate quality for diagnostic / identification purposes. There is no time requirement on updating pantographic radiographs. However, the digital panographic radiograph must adequately represent the current oral condition of the Soldier. Digital radiographs shall be performed on all service members who do not have a digital panograph on file in the DENCLASS system, regardless of when the hardcopy pantograph is dated, or at the discretion of the State Dental Officer.

5.3.4. Each exam shall be entered into the DENCLASS reporting system and annotated on the SF 603 (Health Record - Dental) and the DA 5570 (Health Questionnaire for Dental Treatment) of the Soldier's dental records.

5.3.5. Setup of contractor's dental equipment is to be completed by 16:00 hours the day prior to event commencement. Setup of contractor's dental equipment is the sole responsibility of the contractor. Breakdown of the contractor's dental equipment is the sole responsibility of the contractor.

5.3.6. As required, provide timely feedback and work progress/ status of number of Dental examinations completed to the Office of the State Army Surgeon's POC (or designated representative) as to timelines or factors that may negatively impact processing 8 Soldier exams per hour per dentist.

5.3.7. Provide completion status to Office of the State Army Surgeon's POC (or designated representative) as to time requirements to complete jobs to insure timely processing.

5.3.8. Contractor must notify the Office of the State Army Surgeon's POC (or designated representative) at the end of the event.

5.3.9. Electronic entry of data into the DENCLASS database is required on site at the completion of the Dental Screening mission to include the upload of any radiographs taken during the event.

5.3.10. Contractor shall be licensed on any services rendered and equipment operated during mission.

5.4. Dental Treatment

5.4.1. Based on National Guard Bureau's national statistics, it is estimated that as a result of dental exams, 30% of the alerted & eligible Soldiers will be classified as Classification 3, Non-Deployable without Dental Treatment. This means that an estimated 30% 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 will make a decision based on the authorized dental treatment procedures listed below and convert 30% or more of the contracted population that are eligible per 5.4.2 below with a Dental Readiness Classification (DRC) 3 to DRC 2 or 1 in the event times outlined in Exhibit 3. Contractor will attempt to convert as many DRC 3 during the event to provide a greatest number of medical ready Soldiers.

5.4.2. Authorized dental procedures: Contractor will identify which of the following procedures will not be available for on-site treatment.

(a) Restorative Services:

D2l40-Amalgam-One Surface

D2150-Amalgam-Two Surfaces

D2160-Amalgam-Three Surfaces

D216I-Amalgam-Four or More Surfaces

D2330-Composite-One Surface

D2331-Composite-Two Surfaces

D2332-Composite-Three Surfaces

(b) Posterior composites:

D2335-Composite-Four or More Surfaces

D2391-Composite-One Surface

D2392-Composite-Two Surfaces

D2393-Composite-Three Surfaces

D2394-Composite-Four or More Surfaces

D293 I-Prefabricated Stainless Steel Crown

D2950-Core Buildup, including any pins

D2954-Prefabricated Post and Core

(c) Endodontic Services:

D331O-Anterior Root Canal Therapy

D3320-Bicuspid Root Canal Therapy

(d) Periodontal Services: Periodontal scaling and root planning is authorized only when a periodontal abscess is present)

D4355-Full Mouth Debridement

(e) Oral Surgery Services:

D7140-Extraction, Erupted Tooth or Exposed Root

D72IO-Surgical Removal of Erupted Tooth

D7220-Romoval of Impacted Tooth, Soft Tissue

D7230-Removal of Impacted Tooth, Partial Bony

D7240-Removal of Impacted Tooth, Completely Bony

(f) Orthodontic Services:

D8680-0rthodontic Retention

5.4.3. 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.

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

5.4.5. Prescription Medication Services:

5.4.5.1. Contractor shall set up network & accounts with local pharmacies near event location.

5.4.5.2. Upon need to have dentally treated Soldiers & recommended by licensed dentist, Contractor to arrange for fulfillment of prescription medication for Soldier.

5.4.5.3. Government, Soldier, and/or Contractor are to provide transportation of Soldier to local pharmacy to fill prescription.

5.4.5.4. Contractor shall be invoiced by & submit payment to subcontracted local pharmacy utilized.

5.4.5.5. Local Pharmacy & Contractor to explain prescription medication instructions to ARNG treated Soldier and any other POC at the direction of the Office of the State Army Surgeon. Follow-up conversations between Contractor and ARNG treated Soldier & Supervisor may be necessary depending on complexity of treatment and prescription medication.

5.4.5.6. All contractor expenses related to prescription medication services & case management related services will be forecasted in the overall amount for dental treatment and the contractors cost should be based on the overall treatment hours listed on Exhibit 3.

5.5. Reporting of Services

5.5.1. Contractor will provide a final report at the completion of medical and dental services that contain a detailed account of all service provide to the individual Service Member and totals of each service provided at the event. Report Summaries can be formatted per the contractors needs but will contain at a minimum all the following information:

5.5.2. Event Summary Report will include at a minimum the total number of Soldiers that:

· Checked in/out for Dental Exams

· DRC 1

· DRC 2

· DRC 3 (3A/3B)

· 95%+ conversion rates on soldiers identified as needing dental treatment

· Soldiers that received Dental Bitewing X-Rays

· Dental Panograph X-Rays

· DD Form 2813 submitted SM

· Dental Treatments

· Remaining DRC 3A’s/3B’s

· SF603

· Soldiers checked in/out for Medical

· SF 600 (Soldiers will potential medical issues)

· Profiles

· Hearing Exams & Totals for Each Hearing Class

· Sprint Tests

· EKGs

· Lipid Panels

· HIV Draws

· DNA Draws

· Titer Draws

· Blood Typing

· G6PD

· Each Adult Routine Immunization

5.5.3. Individual Service Member Report will be a by name roster of each service that individual Service Member received , classification of Medical Readiness Classification (MRC) and Dental Readiness Classification. The report will include at a minimum the following information on each Service Member:

· Name (Last, First, MI)

· Full SSN

· Rank

· Dental Exam

· Dental Treatment

· Dental Treatment Procedure

· Ending Dental Class after Treatment

· Dental Readiness Classification (DRC)

· Dental X-ray (Panograph)

· Dental X-ray (Bitewing)

· Dental Notes

· Dental Prescriptions

· PHA

· Vital

· EKG

· Lipids

· HIV

· Blood Typing

· G6PD

· Titer

· DNA

· Pregnancy

· Hearing Exam

· Sprint Test

· Routine Adult Immunizations

· General Notes on Soldiers

· Soldier’s Existing Profile

· Soldier’s New Temp Profile

· Profile Expiration Date

· Soldiers New PULHES

· Case Management Notes

· Soldier screened for Mental Health

5.6. CONTRACTOR MANPOWER REPORTING (CMR)

**5.6.1. The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the MOARNG via a secure data collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/

**5.6.2. Reporting inputs will 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 help desk at: http://www.ecmra.mil.

PART 6

APPLICABLE PUBLICATIONS

6. Applicable Publications (Current Editions)

6.1. The Contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures.

AR 40-501 (Standards of Medical Fitness) http://www.usapa.army.mil AR 40-35 (Dental Readiness & Community Oral Health Prevention) http://www.usapa.army.mil AR 40-66 (Medical Record Administration and Health Care Documentation) http://www.usapa.army.mil AR 40-562 (Immunizations and Chemoprophylaxis) http://www.usapa.army.mil DoDI 6025.19 (Individual Medical Readiness) http://www.dtic.mil/whs/directives/corres/ Applicable DOD Directives, Instructions, and Publications http://www.dtic.mil/whs/directives/corres/ Applicable Medical & Dental ALARACTS https://www.us.army.mil/suite/page/550282 Applicable MILPER Messages https://perscomnd04.army.mil/milpermsgs.nsf

PART 7

ATTACHMENT/TECHNICAL EXHIBIT LISTING

7. Attachment/Technical Exhibit List:

7.1. Attachment 1/Technical Exhibit 1 – Performance Requirements Summary

7.2. Attachment 2/Technical Exhibit 2 – Deliverables Schedule

7.3. Attachment 3/Technical Exhibit 3 - Estimated Workload Data

TECHNICAL EXHIBIT 1

Performance Requirements Summary The Contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

The Contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

TECHNICAL EXHIBIT 2

DELIVERABLES SCHEDULE

TECHNICAL EXHIBIT 3

ESTIMATED WORKLOAD DATA (Example of how Order will be placed)

EVENT DATA

EVENT SCHEDULE

Set Up One Day Prior to Event (0800 – 17:00)

*POC for event Set Up or clarification at anytime during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

*POC during event (to be provided after contract is awarded) Services are coordinated through the Missouri National Guard Office of the State Surgeon, hosting units are responsible for ship equipment and site set up.

INDIVIDUAL SERVICES

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

Ship all lab results to SFC Harmount within a maximum 14 business days after completion of the event, see address below or via coordination of secure fax or encrypted email/email document.

POC for Lab results after Event:

MO Medical Detachment

ATTN: SFC Dawn Harmount

2302 Militia Drive

Jefferson City, MO 65101

WP: 573-638-9809