W912NS-16-R-7001_-_Solicitation.pdf

SEE ADDENDUM

(No Collect Calls)

W912NS-16-R-7001 19-Nov-2015

b. TELEPHONE NUMBER

573-638-9847

8. OFFER DUE DATE/LOCAL TIME

11:00 AM 07 Dec 2015

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W912NS9. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

PAUL CALDWELL

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

USPFO FOR MISSOURI

ATTN: CPT PAUL CALDWELL

7101 MILITARY CIRCLE

JEFFERSON CITY MO 65101

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE W58MZ0 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

HHD, JFHQ-MO

MAJ BETH MILLER

2302 MILITIA DRIVE

JEFFERSON CITY MO 65101-1203

TEL: (573) 638-9649 FAX:

537-638-9619FAX:

TEL: 573-638-9847 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$20,500,000

NAICS:

621498

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF85

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES ESTIMATED

QUANTITY

UNIT UNIT PRICE ESTIMATED AMOUNT

0001 3 Job AMRE Tier Size 1 (up to 200 PAX event)

FFP

All work to be performed in accordance with enclosed Performance Work Statement (PWS)

Please reference enclosed provisions 52.212-1 - Instructions to Offerors and 52.212-2 - Evaluation

FOB: Destination

ESTIMATED

NET AMT

UNIT UNIT PRICE ESTIMATED AMOUNT

0002 6 Job AMRE Tier Size 2 (up to 250 PAX event)

FFP

UNIT UNIT PRICE ESTIMATED AMOUNT

0003 5 Job AMRE Tier Size 3 (up to 300 PAX event)

UNIT UNIT PRICE ESTIMATED AMOUNT

0004 6 Job AMRE Tier Size 4 (up to 475 PAX event)

UNIT UNIT PRICE ESTIMATED AMOUNT

0005 3 Job AMRE Tier Size 5 (up to 550 PAX event)

UNIT UNIT PRICE ESTIMATED AMOUNT

0006 1 Job AMRE Tier Size 6 (up to 650 PAX event)

UNIT UNIT PRICE ESTIMATED AMOUNT

0007 24 Job CMRA Reporting Requirement

FFP

The Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the contractor will report ALL contractor manpower (including subcontractor manpower) required for performance of this contract. The contractor is required to completely fill in all the information in the format using the following web address:

https://contractormanpower.army.pentagon.mil or https://cmra.army.mil/. The required information includes:

(1) Contracting Office, Contracting Officer, Contracting Officer’s Technical Representative

(2) Contract number, including task and delivery order number

(3) Beginning and ending dates covered by reporting period

(4) Contractor name, address, phone number, e-mail address, identity of contractor employee entering data

(5) Estimated direct labor hours (including sub-contractors)

(6) Estimated direct labor dollars paid this reporting period (including sub-contractors)

(7) Total payments (including sub-contractors)

(8) Predominant Product Service Code (PSC) reflecting services provided by contractor (and separate predominant PSC for each Sub-contractor if different)

PSC CODE IS Q403

(9) Estimated data collection cost

(10) Organizational title associated with the Unit Identification Code (UIC) for the Army Requiring Activity (the Army Requiring Activity is responsible for providing the contractor with its UIC for the purposes of reporting this information)[W912NS]

(11) Locations where contractor and sub-contractors perform the work (specified by zip code in the Untied States and nearest city, country, when in an overseas location, using standardized nomenclature provided on website)

(12) Presence of deployment or contingency contract language

(13) Number of contractor and sub-contractor employees deployed in theater this reporting period (by country). As part of its submission, the contractor will also provide the estimated total cost (if any) incurred to comply with this reporting requirement. Contractors may use a direct XML data transfer to the database server or fill in the fields on the website. The XML direct transfer is a format for transferring files from a contractor’s systems to the secure web site without the need for separate data entries for each required data element at the web site. The specific formats for the XML direct transfer may be downloaded from the web site.

Complete this requirement within 30 days from the end of the service or end of each option year.

U.S. Dept of Labor Wage Determinations apply to this contract and can be downloaded at www.wdol.gov. WAGE DETERMINATION Applicable Service Contract Wage Determination attached to solicitation and incorporated by reference: Wage Determination No.: 2005-2309 Revision No.: 16 Date of Revision: 07/08/2015

PERFORMANCE WORK STATEMENT

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 Access and general protection/security policy and procedures. Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

1.5.10 For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management

1.5.11. For contractors that do not require CAC, but require access to a DoD facility or installation. Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), applicable installation, facility and area commander installation/ facility access and local security policies and procedures (provided by government representative), or, at OCONUS locations, in accordance with status of forces agreements and other theater regulations.

1.5.12. Army Training Certification Tracking System (ATCTS) registration for contractor employees who require access to government information systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

1.5.13. For information assurance (IA)/information technology (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of appointment to IA/IT functions

1.5.14. Contractors will be escorted in areas where they may be exposed to classified and/or sensitive materials and/or sensitive or restricted areas. The contractor will coordinate with the COR and/or the facility security office for access when required. (Use when security clearances are not required, i.e. facility repair or construction).

Proposed language: "All contract employees, including subcontractor employees who are not in possession of the appropriate security clearance, will be escorted in areas where they may be exposed to classified and/or sensitive materials and/or sensitive or restricted areas."

1.5.15 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.

1.5.16 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.

1.5.17. 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.

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

1.5.19. 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.

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

1.5.20.1. 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.

1.5.20.2. 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

1.5.20.3. 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.

1.5.20.4. 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.

1.5.20.5. 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

1.5.20.6. 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

1.5.20.7. 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.

1.5.20.8. 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.

1.5.20.9. 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

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

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

1.5.21. 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 Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the contractor will report ALL contractor manpower (including subcontractor manpower) required for performance of this contract. The contractor is required to completely fill in all the information in the format using the following web address: https://contractormanpower.army.pentagon.mil or https://cmra.army.mil/. The required information includes:

(1) Contracting Office, Contracting Officer, Contracting Officer’s Technical Representative

(2) Contract number, including task and delivery order number

(3) Beginning and ending dates covered by reporting period

(4) Contractor name, address, phone number, e-mail address, identity of contractor employee entering data

(5) Estimated direct labor hours (including sub-contractors)

(6) Estimated direct labor dollars paid this reporting period (including sub-contractors)

(7) Total payments (including sub-contractors)

(8) Predominant Product Service Code (PSC) reflecting services provided by contractor (and separate predominant PSC for each Sub-contractor if different) PSC CODE IS Q403

(9) Estimated data collection cost

(10) Organizational title associated with the Unit Identification Code (UIC) for the Army Requiring Activity (the Army Requiring Activity is responsible for providing the contractor with its UIC for the purposes of…