SOLICITATION NOTICE
Q -- Request for Proposal for Medical Surveillances Services
- Notice Date
- 3/28/2012
- Notice Type
- Combined Synopsis/Solicitation
- NAICS
- 621399
— Offices of All Other Miscellaneous Health Practitioners
- Contracting Office
- USPFO for Montana, P.O. Box 4789, Helena, MT 59604-4789
- ZIP Code
- 59604-4789
- Solicitation Number
- W9124V-12-T-0013
- Response Due
- 4/16/2012
- Archive Date
- 6/15/2012
- Point of Contact
- Bryan Baldwin, 406 324 3410
- E-Mail Address
-
USPFO for Montana
(bryan.j.baldwin@us.army.mil)
- Small Business Set-Aside
- Total Small Business
- Description
- This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. This request is a hundred percent set aside for small business concerns. The NAICS code is 621399 and size standard is $7.0 million. The incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-26, Effective 1 June 2008 & Class Deviation 2005-00001. PERFORMANCE WORK STATEMENT 1. PURPOSE 1-1. The purpose of the Montana Army National Guard (MTARNG) Mobile Occupational Medical Surveillance Examination Program is to provide job-related medical surveillance examinations to approximately 120 MTARNG full-time support (FTS) who are potentially exposed to health hazards in the work environment. The contractor will provide all labor, tools, supervision and supplies to conduct mobile medical surveillance for the MTARNG. 1-2. To conduct medical surveillance examinations at two (2) MTARNG work-sites/locations listed below: SITE/LOCATIONAPPROXIMATE NO. OF PERSONNEL a) SITE # 1 CSMS Ft Harrison, MT 80 b) SITE # 2 Army Aviation Support Facility(AASF, Helena MT)40 1-3 Test requirements are different for each location. Therefore, cost quotes should be on a per test basis with the overall requirements being taken into consideration. All numbers are approximate and are not binding. The Montana Army National Guard guarantees at least 50% participation of employees in the program, this is due to the current operation requirements for overseas deployments. 2. Contracting Officer's Representative 2-1 Contracting Officer shall delegate a Contracting Officer's Representative (COR) for this contract. Authorization for tests may be given only by the Contracting Officer or COR. An authorization form must accompany each employee at time of testing. Only those tests approved by the Contracting Officer or COR are authorized. Approval form is included in this PWS. 3. PERFORMANCE PERIOD 3-1 Medical surveillance testing to be completed by 27 July 2012. 3-2 Testing schedule will be coordinated through the Project Officer. Testing will only be performed Tuesday through Thursday and will not begin before 0700 and will stop no later than 1600 at the CSMS for 80 personnel. Location 2 (AASF) testing will be Thursday afternoon with authorized hours of operations from 1300 to 1700 and Friday with authorized hours of operation from 0700 to 1700 for 40 personnel. All personnel are available during the stated time frame. 3-3 Pre-performance conference: Contracting officer will schedule an initial pre-performance conference within fifteen (15) working days after the award of the contract for the purpose of discussing the details of the specifications and implementation of services. Contractor attendance is mandatory. Telephonic conference is authorized. 3-4 In the event of contractor equipment failure, specific testing and/or parts of examinations which are not completed during the testing period are to be completed at a scheduled time mutually convenient to the Contractor and the MTARNG. 4. REFERENCES 4-1 Army Regulation 40-5, Preventive Medicine, July 22, 2005. 4-2 DoD 6055.05-M Occupational Health Surveillance Manual, November 11, 2008. 4-3 U.S. Department of Labor (DOL) Code of Federal Regulations 29 (CFR) 1910, Occupational Safety and Health Standards for General Industry. 4-4 Headquarters, Department of the Army Pamphlet (DA PAM) 40-501, Hearing Conservation. Military references available upon request. 5. PROCEDURES AND STANDARDS 5-1 Contractor must ensure all procedures are conducted in accordance with applicable American Board of Occupational and Environmental Medicine (ABOEM), U.S. Department of Labor, Occupational Safety and Health Administration, and National Institute for Occupational Safety and Health (NIOSH) standards. 5-2 Contractor must ensure all clinical laboratory/chemistry services are performed by a laboratory licensed by the U.S. Department of Health and Human Services Health Care Financing Administration pursuant to the terms of the Clinical Laboratories Improvement Act of 1967 (42 U.S.C. 263a) and the College of American Pathologists. 5-3 Contractor must provide a board certified Occupational Health Physician to conduct job-related medical surveillance physical examinations for approximately 100 MTARNG personnel at two (2) MTARNG work-sites. 5-4 Certified/licensed medical technicians to administer medical surveillance screening/testing. Personnel conducting audiometric testing will be certified by a Council for Accreditation in Occupational Hearing Conservation (CAOHC) approved program. Personnel conducting spirometry will be certified by a National Institute for Occupational Safety and Health (NIOSH) approved program. 5-5 Instrumentation must meet or exceed appropriate performance standards and accuracy must be verified IAW current Occupational Medicine Certification standards. 5-6 Contractor will ensure health care workers fully comply with the requirements of 29 CFR 1910.1030 Bloodborne Pathogens Standard. 6. MEDICAL SURVEILLANCE 6-1 Occupational medical surveillance will be conducted by a board certified Occupational Health Physician. Occupational medical surveillance will consist of a physical examination to include complete occupational health history, height and weight, vital signs, assessment of pulmonary, cardiovascular, gastrointestinal, neurological, dermatological and related systems associated with exposure, complete blood count with differential, blood chemistry screen 25, and urinalysis. 6-2 Based upon occupational exposures, additional testing will include blood lead and ZPP (zinc protoporphyrin) level sampling and analysis, chest x-ray (PA) with B-reader, pulmonary function testing, to include clearance by a physician to wear a respirator, audiometry and mutliphasic vision screening. 7. AUDIOMETRIC TESTING 7-1 Audiograms will be performed with a range of 500 Hz to 6,000 HZ with a zero reference. In addition, notification of changes in hearing should be changed to: average change of +/- 15 dB at 1,000, 2,000, 3,000 or 4,000 Hz. Paper copy and/or electronic format of individual's baselines will be available. Calculations should be without age correction. These changes will ensure that the information will be compatible with our existing system and will meet the requirements for reporting. In addition to the audiogram the following information will be obtained: a.Examiner's name and CAOHC certification number. b.Audiometers model, serial number and calibration date. 8. VISION SCREENING 8-1 Multiphasic vision screening will be performed with the equipment (Titmus type), able to measure the following primary visual skills: a. Visual acuity for distance and near b. Lateral phorias for distance and near c. Vertical phorias for distance and near d. Depth perception e. Color perception f. Peripheral Vision 9.PULMONARY FUNCTION TEST (PFT)/Spirometry and Respiratory Clearance. PFT must be performed by a NIOSH certified Pulmonary Function Technician. The reviewing physician shall determine if the individual is physically able to perform his work and wear a respirator, and what, if any, restrictions are recommended. Documentation will then be made on an Employee Medical Clearance Evaluation Statement (for the personnel receiving PFT's). At a minimum, written PFT documentation will include: a.Forced Vital Capacity (FVC) and percent of predicted. b.Forced Expiratory Volume in one second (FEV1) and percent of predicted. c.Ratio of FVC to FEV1 and percent of predicted. 10.Laboratory Analysis testing will include the following: a.CBC with differential b.Blood Chemistry screen 25 c.Urinalysis with cadmium screening d.Blood Lead and ZPP e.Prostate Specific Antigen 11. Chest X-ray, PA view with B reader (qualification of the radiologist) 12.MOBILE UNIT CONFIGURATION 12-1 Medical surveillance testing is to be accomplished via mobile unit. Features of the unit should include, but are not limited to, a climate-controlled atmosphere, patient waiting/holding area for registration, testing/phlebotomy station, and individual audiometric testing booth. 12-2 Mobile units are to be equipped with separate power source/generator to operate in conditions, if necessary, without access to shore power. 13.MEDICAL REPORTS AND RECORDKEEPING 13-1 Contractor will provide two (2) copies of test results along with a complete listing of results in a ledger form NLT one (1) month after testing has been completed. (Contractor's forms are acceptable). In addition, contractor will provide the following computerized records, formatted for downloading into MTARNG's computerized database (Occupational Health Manager and DOHRS-HC); laboratory, audiometric, and spirometry test results. Results of medical surveillance testing which are questionable and/or critical clinical significance are to be communicated immediately to the Occupational Health Nurse by telephone. 14. QUALITY ASSUARNCE SURVEILLANCE PLAN Quality Assurances Surveillance Plan (QASP): The Contracting Officer's Representative (COR) will monitor contractor performance and complete the Quality Assurance Worksheet provided below weekly and at the conclusion of the event. The Quality Assurance Worksheet will be submitted directly to the Contracting Officer at the conclusion of the services. The Contracting Officer will assume a quality performance rating of "Green" on all measured deliverables unless otherwise notified. The quality rating may change from "Green" to "Red" without notice. We anticipate the COR utilizing the "Yellow" quality rating to alert the contracting office of quality issues that have the potential for a "Red" quality rating if corrective action is not taken. At the end of the contract period of performance the COR will be asked to complete a Quality Performance Review to document the quality performance rating during the performance period. This will be submitted to the Contracting Officer. The COR may submit a Quality Assurance Worksheet at anytime and as often as necessary to document quality levels. If Contractor response to an identified quality deficiency is unsatisfactory, the Contracting Officer will contact the appropriate Contractor representative to implement a plan of action to remedy the identified deficiency. RatingDescription GreenYes performance and technical specifications are being met at AQL. YellowYes, performance and technical specifications are currently being met at the minimum AQL, but the following service / deliverable needs contractor attention. The Customer must identify what component of the deliverable and/or service requires attention. RedNo, performance and technical specifications are not being met at AQL and the following service / deliverable needs immediate contractor resolution. The Customer must identify what component of the deliverable and/or service is below the minimum AQL. QUALITY ASSURANCE PLAN WORKSHEET Performance Rating Deliverable/Service Quality RatingCausative FactorsEffect on MissionAction Required / Date Occupational medical surveillance physical examination to include complete occupational health history, height and weight, vital signs, assessment of pulmonary, cardiovascular, gastrointestinal, neurological, dermatological and related systems associated with exposure, complete blood count with differential, blood chemistry screen 25, and urinalysis. These services will be completed by using contractor provided mobile testing units. GreenComments Unnecessary for "Green" QA Rating. Yellow Red Post surveillance testing to include audiometric testing, vision screening, pulmonary function test and lab tests in accordance with the statement of work and as authorized by the COR. These services will be completed by using contractor provided mobile testing units. GreenComments Unnecessary for "Green" QA Rating. Yellow Red Contractor will provide two (2) copies of test results along with a complete listing of results in a ledger form NLT one (1) month after testing has been completed.GreenComments Unnecessary for "Green" QA Rating. Yellow Red Contractor meets minimum requirements during designated operating hours as identified in paragraph 5 of PWSGreenComments Unnecessary for "Green" QA Rating. Yellow Red MEDICAL SURVEILLANCE AUTHORIZATION FACILITY:_______________________________NAME:____________________________________ TEST DATE:_____________________________ APPOINTMENT TIME:______________________ SSN:____________________________________ DOB:______________________________________ OCCUPATION:___________________________ AUTHORIZATIONACKNOWLEDGMENT _________Audiogram (Hearing)__________ _________Vision Screening__________ _________Blood Lead/ZPP__________ _________PFT with Clearance__________ _________Chest X-ray with B reader__________ _________Physical Exam__________ Please ensure that the completed form is returned to the Contracting Officer or COR. Email all questions to CPT Bryan Baldwin, bryan.j.baldwin@us.army.mil. Do not contact the J1 or Montana Medical Command, as this will only delay receipt of answers. Questions must be received no later than 4:00 pm MST April 3, 2012. Answers will be provided with questions on a non-attribution basis and will be posted to the Montana Army National Guard Business Opportunities website as an amendment to this solicitation. Instructions to Offerors Offerors shall provide a firm, fixed price for health care surveillance services IAW the performance work statement: CLINDESCRIPTIONQUANTITYU/MAMOUNT 0001Physical examination, 120Ea____.____ occupational health history, vital signs, CBC, UA, Chem 25 0002Audiometric Testing120Ea____.____ 0003Vision Screening120Ea____.____ 0004Blood Lead and ZPP Levels45Ea____.____ 0005Chest X-Ray (PA) with B reader20Ea____.____ 0006Pulmonary Function Testing 20Ea____.____ In addition to pricing, contractor shall provide a technical narrative describing their technical capability to perform the services in the performance work statement 52.212-2, Evaluation-- Commercial Items (January 1999). The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be the most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers: Price and Technical Capability. If services from offerors are found to be technically equivalent, price will be the determining factor. The following Federal Acquisition Regulation (FAR) and its supplements DFAR and AFAR provisions and clauses apply to this acquisition: 52.204-7 Central Contract Registration FEB 2011 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.212-1 Instructions to Offerors - Commercial Items JUN 2008 52.212-2 Evaluation-Commercial Items JAN 1998 52.212-3 ALT I Offeror Representations and Certifications--Commercial Items APR 2002 52.212-4 Contract Terms and Conditions--Commercial Items JUN 2010 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders--Commercial Items FEB 2010 52.219-6 Notice of Total Small Business Set-Aside NOV 2011 52.219-28 Post-Award Small Business Program Representation APR 2009 52.222-21 Prohibition of Segregated Facilities FEB 1999 52.222-3 Convict Labor JUN 2003 52.222-19 Child Labor - Cooperation with Authorities and Remedies FEB 2008 52.222-21 Prohibition of Segregated Facilities FEB 1999 52.222-26 Equal Opportunity MAR 2007 52.222-36 Affirmative Action for Workers with Disabilities JUN 1998 52.222-41 Service Contract Act of 1956 NOV 2007 52.222-50 Combating Trafficking in Persons AUG 2007 52.223-5 Pollution Prevention and Right to Know Information MAY 2011 52.223-18 Encouraging Contractor Policy to Ban Text Messaging While Diving AUG 2011 52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.228-5 Insurance-Work on a Government Installation JAN 1997 52.232-18 Availability of Funds APR 1984 52.232-33 Payment by Electronic Funds Transfer--Central Contractor Registration OCT 2003 52.233-2 Service of Protest SEP 2006 52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.237-2 Protection of Government Buildings, Equipment and Vegetation OCT 1995 52.252-2 Clauses Incorporated by Reference FEB 1998 252.201-7000 Contracting Officer's Representative AUG 1992 252.203-7000 Requirements Relating to Compensation of Former DoD Officials 252.203-7002 Whistleblower Rights 252.204-7004 Alt A Central Contractor Registration (52.204-7) Alternate A SEP 2997 252.212-7001 (Dev) Contract Terms and Conditions Required to Implement Statutes or Executive Orders Applicable to Defense Acquisitions of Commercial Items (Deviation) MAR 2008 252.223-7006 252.225-7001 Buy American Act-Balance of Payments Program Certificate JUN 2005 252.232-7010 Levies on Contract Payments DEC 2006 252.243-7002 Requests for Equitable Adjustment MAR 1998 You can visit the website at http://farsite.hill.af.mil/ for the provisions and clauses needed for this synopsis/solicitation. Offers must be submitted by hard copy to the USPFO for Montana, ATTN: CPT Bryan Baldwin, Purchasing and Contracting, 1956 Mt Majo Street, Post Office Box 4789, Fort Harrison, Montana 59636-4789, no later than April 16, 2012 by 12:00 P.M. Mountain Standard Time. Offers may also be submitted electronically to bryan.j.baldwin@us.army.mil with the same deadline. If you have any questions, please contact CPT Bryan Baldwin at 406-324-3405 or email bryan.j.baldwin@us.army.mil
- Web Link
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FBO.gov Permalink
(https://www.fbo.gov/spg/USA/NGB/DAHA24/W9124V-12-T-0013/listing.html)
- Place of Performance
- Address: USPFO for Montana P.O. Box 4789, Helena MT
- Zip Code: 59604-4789
- Zip Code: 59604-4789
- Record
- SN02707567-W 20120330/120328235016-b267bd1aa0f2d1c824bdaebc71a0478c (fbodaily.com)
- Source
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