02. PWS LN Competent Physician 21 Jul 2021 v.1.pdf

PERFORMANCE WORK STATEMENT

LOCAL NATIONAL COMPETENT PHYSICIAN SERVICES

OCCUPATIONAL HEALTH & SAFETY PROGRAM

AVIANO AIR BASE, ITALY

21 July 2021

Table of Contents

1. GENERAL

2. SCOPE OF WORK

3. ADMINISTRATION

4. KEY PERSONNEL

5. SECURITY REQUIREMENTS

6. MEDICAL RECORDS AND PRIVACY LAW COMPLIANCE

7. DEFINITIONS

8. DESCRIPTION OF SERVICES

9. REPORTING OF EXAMINATION RESULTS

10. MEETINGS

11. WORKSITE VISITS

12. EXAMINATIONS / TESTS

13. HOURS OF OPERATIONS

14. FURNISHED ITEMS AND SERVICES

15. GENERAL INFORMATION

1. GENERAL

1.1 This is a requirement for a non-personal services contract. The Contractor shall provide management and supervision, administration, personnel, transportation, tools, equipment and materials to execute Local National (LN) Employees Occupational Health Services in accordance with (IAW) the Italian Legislative Decree Law 81/2008 to include all future amendments and supplements (Testo Unico sulla Salute e Sicurezza sul Lavoro, D.lgs. 9 Aprile 2008, n. 81, successive modifiche e integrazioni), hereafter referred as D. L. 81/2008 s.m.i., as well as Conditions of Employment for Local National Employees of the U.S. Armed Forces in Italy (COE) effective 1 November 2018, to include all future updates and revisions. The Contractor shall be certified and credentialed Occupational Health Physician (Medico Competente), hereafter referred as OHP.

2. SCOPE OF WORK

2.1 The OHP shall collaborate with the employer (U.S. Government) in order to perform the health surveillance and the risk assessment of all health and safety hazards and for any other related duties reported in any applicable Italian occupational health and safety laws. The OHP shall perform occupational medical surveillance examinations, site-visits, surveys, meetings, and other special occupational medical evaluations concerning all designated Local National (LN) employees working in the Aviano AB installation under the 31st Fighter Wing area of responsibility, to include DeCa, DoDDs, DLA, AMC and AAFES personnel, as well as other LN personnel supported by the Aviano Civilian Personnel Office, in accordance with this Performance Work Statement (PWS).

2.2 Occupational Health Surveillance examinations consist of initial pre-employment, periodic, termination, reassignment, and ongoing examinations as outlined in Article 41 “Sorveglianza Sanitaria” of Italian D. L. 81/2008 s.m.i..

2.3 The OHP assumes full accountability for responsibilities and obligations of the Employer (U.S. Government) compliance with applicable Local National Employee Occupational Health Services, Italian D. L. 81/2008 s.m.i..

2.4 The OHP shall perform Risk Assessments of LN employees’ worksites and activities in coordination with U.S. Government personnel to include, at a minimum, the Responsible for Services of Prevention and Protection (RSPP/ASPP) (Addetti e Responsabili del servizio di prevenzione e protezione dai rischi).

2.5 The OHP shall participate and perform Risk Assessments and evaluations of LN employees’ worksites at a minimum once a year or at different frequency depending on the risk assessment evaluations, in accordance with Article 25 (Obblighi del medico competente) of the Italian D.

L. 81/2008 s.m.i..

2.6 The OHP shall utilize, among others but not limited to, results of workplace risk assessments provided by Prevention and Protection Officer (PPO), 31AMDS/SGPB, 31FW/SE, and

31CES/CEF, workplace walkthroughs, reports by ESRs and Local National workers, and results of occupational physical examinations to determine if a potential health threat exists.

2.7 The OHP is expected to use innovative approaches to efficiently and effectively accomplish the Performance Work Statement requirements in a timely manner at a reasonable cost.

2.8 The OHP shall provide all materials, tools and equipment to execute Local National (LN) Employees Occupational Health Services, with exclusion of the following items that are furnished by the Government of the USA: two desks, ten chairs, an examination table and a file cabinet which are located at Prevention and Protection Service (P&PS) facility, BLDG 898, Area F, Aviano AB.

2.9 The OHP’s performance will be evaluated by the Mission Owner (MO) through anonymous questionnaire filled out by employees at the end of the visits, customers’ complaints and civilian personnel office feed-back.

3. ADMINISTRATION

3.1 The OHP shall provide sufficient organizational resources and management controls to ensure that this task is performed efficiently, accurately, on time, and in compliance with the requirements of this PWS and all Applicable Laws and Regulations.

3.2 Except for those services specifically stated to be U.S. Government furnished, the OHP shall furnish and maintain all equipment, supplies, records and all other items necessary to perform all services outlined in this PWS.

3.3 The OHP shall perform all examinations at Base Facilities, mainly at Prevention & Protection Service (P&PS) facility (Bldg. 898, Area F), using his/her own equipment and assistant(s).

3.4 The OHP shall coordinate Specialty examinations and/or care with the Prevention & Protection Service (P&PS) and CPO, prior to scheduling of re-referrals (e.g. drug and/or alcohol testing).

3.5 Language: The OHP shall provide during the performance of services under this contract, at least one individual who is able to read, write, speak, and understand Italian and English language. All written communication, including all reports and results of medical examinations, work site surveys, and related documents, shall be completed in English language.

4. KEY PERSONNEL

4.1 The OHP shell be appointed by the Employer in accordance with art 18, let. a of the Italian D. L. 81/2008 s.m.i.

4.2 The OHP performing under this contract shall be qualified physicians, fully licensed to practice medicine in Italy, with steady current credentials in Occupational Health Surveillance (Medico Competente) in accordance with Article 38 (Titoli e requisiti del medico competente) of the Italian D. L. 81/2008 s.m.i.. The OHP shall maintain license and credentials in accordance with Article 38 sub (3) of the Italian D. L. 81/2008 s.m.i.. The OHP shall be registered and maintain registration in the Italy National List of OHPs (Elenco nazionale dei Medici competenti) for the entire duration of the contract period of performance.

4.3 The OHP shall submit copies of licenses and credentials utilized for the performance on this contract to the Contracting Officer.

4.4 The OHP shall comply with the general intent and specific policies set forth in this PWS and the relevant U.S. and Italian Laws and regulations on safety at work.

5. SECURITY REQUIREMENTS

5.1 The OHP will be granted access to U.S. Air Force worksites and installations for official business, with the appropriate coordination of the Aviano AB Military Community.

5.2 Physical Security. The OHP shall be responsible for safeguarding all Government equipment, information and property provided for OHP use.

5.3 The OHP shall meet local site requirements for Base Access. All non-US personnel shall meet any Aviano Base required Operations Security training and requirements as well as local host country background investigations.

5.4 Standard. The OHP shall observe and comply with all rules, policies, and regulations prescribed by the installation Command and other federal authorities concerning eating and smoking areas, fire, safety, sanitation, security and possession of firearms or other lethal weapons.

5.5 The OHP entering the Government installation shall abide by all security regulations for the installation which may be in effect during the contract period and shall be subject to such checks as may be deemed necessary to ensure that no violations occur. No employee will be permitted on the installation when such checks reveal that his/her presence would be detrimental to the security of the installation.

6. MEDICAL RECORDS AND PRIVACY LAW COMPLIANCE

6.1 The OHP shall process and store all data necessary for the fulfillment of the required performance and for maintaining of all accountability records in protected data processing systems in accordance with Italian Data Protection Authority (DPA) Laws, (Garante per la Protezione dei Dati Personali) as well as Health Insurance Portability and Accountability Act

(HIPAA).

6.2 The OHP and his/her ancillary staff shall maintain strict confidentiality in accordance with Italian Laws and Regulations as well as HIPAA.

6.3 The OHP shall deliver to the employer, at the termination of the employment, the medical records in accordance with Article 25 sub (d) of Italian D. L. 81/2008 s.m.i..

6.4 The OHP shall deliver to the employee, at the termination of the employment, a copy of the medical record and risk assessment in accordance with Article 25 sub (e) of Italian D. L.

81/2008 s.m.i..

7. DEFINITIONS

As used throughout this Performance Work Statement, the following terms shall have the meaning set forth below:

7.1 CONTRACTING OFFICER (CO): A person appointed with the authority to enter into, administer and terminate contracts on behalf of the Government.

7.2 QUALITY ASSURANCE PROGRAM COORDINATOR (QAPC): Those actions taken by the U.S. Government to ensure services meets the requirements of the contract.

7.3 PERFORMANCE WORK STATEMENT (PWS): A document that accurately describes a service in terms of the output requirements and the required quality level of standard of acceptable performance of those outputs.

7.4 MISSION OWNER (MO): U.S. Government employee responsible for evaluating the contractor’s performance in accordance with PWS.

7.5 LOCAL NATIONAL: Italian civilian employee working on Base, (tenants included, contractors and ITAF excluded).

7.6 BIOENVIRONMENTAL FLIGHT (31AMDS/SGPB): Organization responsible for USAF industrial hygiene in accordance with USAF criteria.

7.7 SAFETY OFFICE (31FW/SE): Organization responsible for USAF safety in accordance with USAF criteria.

7.8 FIRE PREVENTION OFFICE (31CES/CEF): Organization responsible for USAF fire prevention in accordance with USAF criteria

7.9 PREVENTION & PROTECTION SERVICE (P&PS): Organization responsible for L/N safety and industrial hygiene in accordance with EU/Italian criteria.

7.10 PREVENTION & PROTECTION OFFICER (P&PO – 31FW/CCPP): Chief of P&PS.

7.11 EMPLOYEES’ SAFETY REPRESENTATIVES (ESRs): Employee’s members of the P&PS as per Italian D. L. 81/2008 s.m.i., article 2 para. 1, sub (i).

7.12 CIVILIAN PERSONNEL OFFICE (CPO): Aviano Air Base Civilian Personnel Office.

7.13 GEOGRAFICAL SEPARATED UNITS (GSUs): Units of the Italian territory employing LN belonging to 31FW and Aviano Air Base CPO

8. DESCRIPTION OF SERVICES

This section specifies details as to the scope of work to be performed under the contract:

8.1 The Contractor shall provide Occupational and Environmental Health Surveillance Services to the Aviano AB Local National (LN) employees of the U.S. Armed Forces in Italy, as designated in paragraph 2.1. The Contractor shall provide specialized Occupational Health Surveillance expertise and support to Local National employees.

8.2 The Contractor shall organize and perform Occupational Health Surveillance in accordance with the Italian L. D. 81/2008 s.m.i.. and provide the employer and the employee with a written copy of the medical certificate

8.3 The Contractor shall guarantee the performance of Occupational Health Surveillance and Examinations in accordance with Article 41 (Sorveglianza Sanitaria) of the Italian L. D.

81/2008 s.m.i.. Here below a summary excerpt from Article 41:

a. Preventive Health Examination aimed at proving the absence of counter-indications to the task that the worker will have to perform in order to evaluate his or her suitability to the specified task;

b. Periodic Health Examinations to verify employees' health suitability to specific tasks;

c. Health Examinations upon employees' request;

d. Health Examinations when changing duty position, to verify the suitability in the specific tasks;

e. Health Examinations upon termination of employment;

f. Pre-employment Health Examinations.

g. Health Examinations after a period exceeding sixty consecutive sick leave days in order to verify fitness for duty in the specific tasks.

8.4 Civilian Personnel Office shall provide OHP with a roster of Local National employees, related jobs descriptions and current list of exposed personnel and any other pertinent data upon request and coordination with Prevention and Protection Officer (PPO).

8.5 The OHP shall coordinate appointments to visit employees and deliver pertinent correspondence to employees through Civilian Personnel Office (CPO) and/or Prevention and Protection Officer (PPO).

8.6 The OHP shall provide individual counseling and information to LN employees with specific reference to their area of responsibilities.

8.7 The OHP shall perform Risk Assessments of LN employees’ worksites in coordination with U.S. Government personnel to include, at a minimum, the Representatives of Prevention and Protection Service, RSPP/ASPP, (Addetti e Responsabili del servizio di prevenzione e protezione dai rischi).

8.8 The OHP shall participate and perform Risk Assessments and evaluations of LN employees’ worksites, at a minimum once a year or at different frequency depending on the risk assessment evaluations, in accordance with Article 25 (Obblighi del medico competente) of the Italian D.L.

81/2008 s.m.i., as well as in accordance with SPISAL directives and regulations (Servizio Prevenzione, Igiene e Sicurezza negli Ambienti di Lavoro).

8.9 The OHP shall submit Work Site Visit Reports in the English language to the MO and/or Technical Representative of the Contracting Officer and to the ASPP/RSPP.

8.10 The OHP shall notify the Employer, through the Prevention and Protection Officer whenever the outcome of the medical surveys and/or visits outlines that a previously unrecognized/uncontrolled health or safety hazard exists in a work place.

8.11 The OHP shall make recommendations for personal protective equipment as appropriate.

8.12 The OHP shall assess ergonomic hazards for 31 FW LN employees assigned and make appropriate recommendations.

8.13 The OHP shall assist the Prevention and Protection Officer in the evaluation of all health and safety hazards, along with recommended preventive and protective actions.

8.14 The OHP shall provide instructions and any related information pertinent to occupational health as well as any other related matters if determined to be necessary and/or when requested by management.

8.15 The OHP shall assist Prevention & Protection Service Office (P&PS) in maintaining Wing compliance with all European /Italian safety applicable laws.

8.16 The OHP shall collaborate with the Prevention & Protection Service Office (P&PS) on the accomplishment and exploitation of health promotion plans.

8.17 IAW article 39 of the Italian D. L. 81/2008 s.m.i. it is possible to have other competent physicians serving the geographically separated units for which Aviano AB OHP will remain the coordinator (Camp Darby & Ghedi Air Force Base).

8.18 In case of replacement of the OHP all information and documentation shall be passed to the next Competent Physician in order to ensure service continuity.

9. REPORTING OF EXAMINATION RESULTS

9.1 The OHP shall transmit copies of the Physician Statements “Giudizio d’Idoneità alla mansione specifica” in the Italian and in the English language, in PDF format, to the Civilian Personnel Office and to the Employee.

9.2 The OHP shall express his/her recommendations and submit required reports in writing in a detailed and timely manner. Deadlines will be coordinated with Prevention and Protection Officer (PPO) or Civilian Personnel Office (CPO). Prevention and Protection Officer (PPO) or Civilian Personnel Office (CPO) may require that the OHP provides his/her recommendation in writing also for specific case/contingent situations. Reports shall indicate, at a minimum, Occupational Health summary results, frequency and Risk Assessments in accordance with Article 25 (Obblighi del medico competente) of the Italian D. L. 81/2008 s.m.i.. Correspondence shall be bilingual, (EN/IT).

9.3 The OHP shall update and maintain employees’ medical records (Cartella Sanitaria), in accordance with Article 25 (Obblighi del medico competente), of the Italian D. L. 81/2008 s.m.i.. The OHP shall process, store and maintain safeguard employees’ data and medical records (Cartella Sanitaria), in a secure environment, in accordance with Italian Data Protection Authority (DPA) Laws, (Garante per la Protezione dei Dati Personali) as well as Health Insurance Portability and Accountability Act (HIPAA).

9.4 The OHP shall promptly report to the appropriate Italian authorities, (SPISAL, INAIL, ISPESL, etc.) cases of occupational illnesses discovered during employees’ examinations. The Contractor shall, simultaneously, inform the U.S. Government personnel, the MO and/or Technical Representative of the Contract Officer, the ASPP/RSPP and the Civilian Personnel Office.

10. MEETINGS

10.1 The OHP shall attend meetings (to include periodic meetings in accordance with article 35 (Riunione periodica) of the Italian D. L. 81/2008 s.m.i. ).

10.2 The OHP shall participate in the development of Risk Assessment Document meetings in accordance with Article 29 (Modalità di effettuazione della valutazione dei rischi) of the Italian D. L. 81/2008 s.m.i..

11. WORKSITE VISITS

The OHP shall join Prevention and Protection Officer (PPO) when required as below detailed:

11.1 General Worksite Risk Assessments and Evaluations: The U.S. Air Force personnel will facilitate and coordinate local LN worksites visits for Risk Assessment and Evaluations. The RSPP/ASPP and the MO and/or Technical Representative of the Contracting Officer are recognized as the persons responsible to coordinate all worksites visits. Work site visits will be conducted on an average of two (2) per month with the expected time for completion.

11.2 Worksite Hazard Evaluations: The U.S. Air Force personnel will facilitate and coordinate local LN hazardous worksites visits for Risk Assessment and Evaluations. The RSPP/ASPP and the MO and/or Technical Representative of the Contracting Officer are recognized as the persons responsible to coordinate all hazardous worksites visits.

11.3 Worksite Risk Assessment and Evaluation visits must be coordinated through MO and/or Technical Representative of the Contract Officer and RSPP/ASPP not later than 30 days prior to the visit. Complete worksite visit reports must be provided to the entitled management within ten (10) working days from the date of the visit.

12. EXAMINATIONS / TESTS

12.1 LNs HEALTH EXAMINATIONS: The OHP shall provide Health Examinations as described in paragraph 8 of subject PWS.

12.2 VISION SCREENING: The OHP shall perform vision screening in accordance with employee’s worksite, duty position and established Risk Assessments reports.

12.3 AUDIOGRAMS: The OHP shall perform Audiograms in accordance with employee’s worksite, duty position and established Risk Assessments reports.

12.4 PULMONARY FUNCTION TESTING (PFT): The OHP shall perform PFT testing in accordance with employee’s worksite, duty position and established Risk Assessments reports.

12.5 SPECIALIST EXAMINATION AND CERTIFICATION: The OHP shall refer employees to a specialist in order to complete more extensive testing and evaluation. Unit price to include testing and evaluation performed by Specialist, referrals, special tests and/or examinations provided by the specialist shall be scheduled in coordination with the Aviano AB CPO and MO.

12.6 CHEMISTRY: The OHP shall advise and review Chemistry tests in accordance with employees’ worksite, duty position and established Risk Assessments reports.

12.7 URINALYSIS (UA): The OHP shall advise and review Urinalysis (UA) tests in accordance with employees’ worksite, duty position and established Risk Assessments reports.

12.8 METAL SCREENING: The OHP shall advise and review Metal Screening tests in accordance with employees’ worksite, duty position and established Risk Assessments reports.

12.9 BLOOD COLLECTION: The OHP shall advise and review Blood Collection in accordance with employees’ worksite, duty position and established Risk Assessments reports.

12.10 DRUG / ALCOHOL TESTING: The OHP shall ensure that all necessary drug/alcohol testing as required by Italian D. L. 81/2008 s.m.i., in accordance with DPR n. 309 of 9 October 1990, C.U. of 30 October 2007 and Attch.1 of 18/09/2008, Law n. 125 of 30/03/2001 and Attch.1 of 16/03/2006 and any other applicable directives, procedures and laws into force will be performed on all individual assigned to the specific operational duties identified.

12.11 LABORATORY REFERRALS (POSITIVE DRUG / ALCOHOL TEST): The OHP shall overview procedure of urine samples submittal to a certified laboratory when the drug / alcohol testing performed are positive. Positive results will be reported to CPO and follow up will be conducted IAW with Italian D. L. 81/2008 s.m.i., in accordance with DPR n. 309 of 9 October 1990, C.U. of 30 October 2007 and Attch.1 of 18/09/2008, Law n. 125 of 30/03/2001 and Attch.1 of 16/03/2006, Regional and local procedures directives and laws and any future and applicable.

13. HOURS OF OPERATIONS

13.1 The OHP shall be available in presence at least one day a week and by phone or email five

(5) days a week. Hours of operations may be encompassed between 0830 and 1930 hours.

13.2. The Contractor shall provide the required services during the normal workweek hours Monday through Friday, exclusive of Italian holidays, U.S. Federal Holidays and officially conceded “bridge days“.

13.3 The Contractor shall be available for scheduling appointments within the working week, from Monday to Friday (except on Italian Holidays, as listed below) from 0800-1700 hrs at a telephone number provided by the OHP to the Aviano AB CPO and the MO. The following are recognized U.S. Federal and Italian holidays:

U.S. Federal Holidays New Year’s Day 1st January Martin Luther King’s Day 3rd Monday in January President’s Day 3rd Monday in February Memorial Day Last Monday in May Juneteenth 19th June Independence Day July 4th Labor Day 1st Monday in September Columbus Day 2nd Monday in October Veterans Day 2nd Monday in November Thanksgiving 4th Thursday & Friday in November Christmas Day 25th December

Italian Holidays 1 January New Year's Day 6 January Day of Epiphany Easter Monday Local PSD (April) 25 April Liberation Day 1 May Labor Day 2 June Republic Day 15 August Assumption Day 1 November All Saints' Day 8 December Immaculate Conception 25 December Christmas Day 26 December Saint Stephen's Day

14. FURNISHED ITEMS AND SERVICES

14.1 As outlined at paragraph 2.8, the Government will allow the contractor to use an area/rooms at Prevention and Protection Service (P&PS) facility, BLDG 898, Area F (subject to change or relocation). The rooms will have utility services at existing outlets for use or as required for work to be performed under this contract: electricity, fresh water, and bathrooms. In addition the following items will be furnished by the Government: two desks, ten chairs, an examination table and a file cabinet. The Government will not alter existing utility systems for contractor operations. No alterations to the facilities will be authorized. The contractor shall return the facilities to the Government in the same condition as received. Facilities only for the specific purpose identified in the contract. A key to the room to the contractor and no custodial services will be provided.

15. GENERAL INFORMATION

14.1 CONTRACTOR PERSONNEL. All work under this contract must be performed in a skillful manner. Contractor and his/her employees must conduct themselves in a proper, efficient, courteous, and business-like manner. The Government reserves the right to remove any employee who endangers persons or property, whose continued employment is inconsistent with the interests of military security, or whose presence deters the accomplishment of work.

14.2 CONTRACTOR COMMUNICATIONS. To facilitate communication between Government and contractor, contractor must designate and maintain an email account(s) and contact telephone number(s) for the life of the contract.

14.3 ALCOHOL AND DRUGS. The consumption of alcohol or drugs while on duty is strictly prohibited. Contractor personnel shall not consume alcohol or drugs within eight (8) hours prior to reporting to duty. Contract personnel found under the influence of alcohol or drugs during duty will be immediately removed from duty. The contractor will be notified and will provide a replacement immediately. Any contractor personnel removed from duty for alcohol or drug use will be prohibited from accessing the Base under this or any other contract.

14.4 LIABILITIES AND RESPONSABILITIES. The contractor is responsible for all damages to persons or property that occurs during the performance of this contract as a result of the contractor’s fault or negligence. The contractor is also responsible for all work performed until completion and acceptance of the work.

14.5 GOVERNMENT QUALITY ASSURANCE. Government will appoint a MO to assess the contractor to ensure services are received. The MO will assess the contractor’s performance as outlined at paragraph 2.9. The Government may inspect each task as completed or increase the number of quality assurance inspections if deemed appropriate. If the MO determines that the complaint is invalid, the MO will document the findings and notify the customer. If the MO determines the complaint is valid, it will inform the contractor and the contractor must initiate corrective actions. However, in cases of disagreement the CO will be informed and will make a final determination of action to be taken.

14.6 SAFETY AND HEALTH PROGRAM. Contractor must develop and maintain a Safety and Occupational Health plan, which meets all applicable Aviano AB and Italian Standards to include, but not limited to, requirements outlined in the Air Force Consolidated Occupational Safety Instruction, AFI 91-203, and Italian D. L. 81/2008 s.m.i.. The contractor must use and furnish, and personnel must use Personal Protective Equipment (PPE) and clothing to safely perform duties. The contractor must immediately notify the MO and CO of any adverse safety and occupational health conditions pertaining to its employees, Government personnel, and Government property while performing contractual services. A written report detailing the occurrence must be given to MO within 2 working days after incident occurrence. If injuries are life threatening, the contractor shall immediately contact emergency services. On base Emergency Service contact and phone number info will be provided after contract award.

Contractor shall take a safety briefing with Wing Safety representatives.