564-19-101 Safety During Contruction.pdf

Veterans Health Care System of the Ozarks (VHSO)

VHSO Memorandum Number 15-00-88

May 22, 2015

Safety and Health During Construction Activities

1. Purpose: To establish policy and procedures to ensure that construction projects will be planned, coordinated and regularly inspected to ensure compliance with applicable fire, infection control, environmental, security, safety, and occupational health regulations and policies.

2. Policy

a. It is the Policy of the VHSO to operate under a comprehensive construction safety program that seeks to reduce the potential for injury and illness to Veterans Affairs (VA) patients, employees, and visitors that might result from unsafe construction activities, to increase the level of construction safety expertise of VA employees, to decrease the potential for serious Occupational Safety and Health Administration (OSHA) violations, to provide a guideline for addressing safety-related construction issues, and to reduce the potential for property and liability exposures due to construction-related activities.

b. Construction activities shall be defined to include delegated minor or non-recurring maintenance projects performed by contractors or purchase and hire personnel, as well as facility-level projects performed by contractors, purchase and hire personnel or facility engineering personnel. Construction shall also include non-delegated projects including majors, and Veterans Health Care System of the Ozarks (VHSO) shall coordinate those construction impacts with the project’s Resident Engineer through VHSO’s single point of contact. This definition also applies to enhanced use and lease projects related to structures for which VHSO maintains management responsibility or authority.

3. Responsibility

a. Medical Center Director

(1) Establishing and monitoring an effective facility Construction Safety Program.

(2) Establishing a Multi-Disciplinary Team (Construction Safety Committee) with representatives from the following program areas:

(a) Infection Control

(b) Patient Safety

(c) Occupational Safety and Health

VHSO MCM 15-00-88

(d) VA Police

(e) Engineering (Facilities Management)

(f) Engineering (Projects Management)

(g) Green Environmental Management System (GEMS)

(h) Emergency Program Coordinator

(i) Local Union Safety Representatives (from affected bargaining units)

(j) Contracting

(k) Employee Occupational Health

(3) Designating a Construction Safety Officer(s) (CSO) that has the necessary training, experience, and authority to carry out their responsibilities with respect to safety and health during construction activities to oversee construction safety.

(4) Ensuring that Competent Persons (CP)s who have the necessary training, experience, and authority to carry out their responsibilities with respect to safety and health during construction activities are designated for the project. Title 29 Code of Federal regulations (CFR) 1926.32(f) states “competent person” means one who is capable of identifying existing and predictable hazards in the surroundings and working conditions which are unsanitary, hazardous or dangerous to employees, and who has the authorization to take prompt corrective measures to eliminate them.” Qualified VA staff must be appointed to serve as CP for construction work performed by VA employees. The name and qualifications of the CP must be identified in writing and noted in the minutes of the facility Safety Committee (or equivalent body) responsible for the safety management functions as defined under the Joint Commission (TJC) Environment of Care Standards.

(5) Ensuring that the Construction Safety Committee actively engages all areas of construction safety and fulfills all of its responsibilities.

(6) Developing and implementing a written facility policy addressing the responsibilities of the Construction Safety Committee.

(7) Ensuring that VA staff receives training as follows:

(a) Contracting Officer (CO) completes the OSHA 30 hour of Construction Safety Training and at least 10 hours of construction safety training every 2 years.

(b) Appointed CPs, Contracting Officer’s Representatives (COR)s, Construction Safety Officers, facility Safety Staff, and GEMS coordinator complete OSHA’s 30-hour Construction Safety Training initially, and subsequently complete at least 10 hours of Construction Safety Training at least every 2 years.

(c) Chief Engineers/Facilities Management, Resident Engineer(s) (RE), supervisors, and foremen who oversee construction work complete OSHA’s 30-hour Construction Safety Training initially, and subsequently complete at least 10 hours of Construction Safety Training at least every 2 years.

(d) Multi Disciplinary Team members for Patient Safety, Infection Control, VA Police, Emergency Management, Local Union representative, and Employee Health complete at a minimum the OSHA 10 hour Construction Safety Course or VA equivalent and receive a minimum of 10 hours construction training every 2 years

(8) Ensuring that construction contracts awarded after July 31, 2005, specify that on-site general and sub-contractor’s construction workers have completed at least 10 hours of Construction Safety Training, the 30-hour OSHA Construction Safety Training course, or other relevant competency training, as determined by the Construction Safety Committee with input from the Multi-Disciplinary Team. The determination for training is based on the project hazards and complexity, state and federal regulations and VA requirements.

b. Associate Director

(1) Completing responsibilities delegated from the Medical Center Director, as appropriate, for oversight of these policies.

c. Chief, Engineering Service

(1) Working through safety and health staff, CORs, maintenance staff, contractors, and the Construction Safety Committee to plan, coordinate, and monitor the Construction Safety Program for all projects at the facility.

(2) Working with contractor and Veterans Health Administration (VHA) facility staff to coordinate and monitor an effective Construction Safety Program for projects under their direction.

(3) Supporting the periodic inspections of construction sites.

(4) Acting as the Safety Officer in accordance with the Department of Veterans Affairs Acquisition Regulations (VAAR) 836.236-87 and ensuring contractors comply with VA safety and health policies and procedures, and contract requirements. This also applies to RE(s).

(5) Serving on the facility Construction Safety Committee to ensure contracts meet the committee’s requirements.

(6) Supporting the Construction Safety Officer, Facility Safety Manager, Contracting Officer, and engineering staff in implementing the Construction Safety Program.

(7) Supporting the CP, Safety Officer, Infection Control Practitioner, CO, and staff in implementation of the Construction Safety Program.

(8) Working with contracting staff to ensure competent staff is assigned as CORs to oversee work.

d. Supervisor of Operations and Maintenance

(1) Participating in periodic inspections of in-house construction sites to ensure compliance with safety elements of the construction contract and performance of the program.

(2) Ensuring that in-house work forces have necessary training and competency for tasks being performed.

e. Chief of Biomedical Engineering

(1) Ensuring that all construction accomplished in support of major equipment installations (as a part of the equipment purchase) are in compliance with the site Construction Safety Program policy and procedures.

f. Contracting Officer (CO) and Contracting Officer’s Representative (COR).

(1) Ensuring that all solicitations and contracts include the Federal Acquisition Regulation (FAR) clause found in Federal Acquisition Regulation (FAR) 52.236-13, Accident Prevention, and Veterans Affairs Acquisition Regulation (VAAR) clause found in VAAR 836.236-87.

(2) Designating, in writing, the CSO to serve as the Safety Officer for VHA contracts; and the RE to act as the Safety Officer for the Office of Construction & Facilities Management (CFM) contracts (applies to CO).

(3) Adding paragraph (f) found in Federal Acquisition Regulations (FAR) 52.236- 13 to the basic clause if the contract will involve work of a long duration or hazardous nature, or performance on a government facility that, on the advice of CSO or COR, involves hazardous materials or operations that might endanger the safety of the public or government personnel or property.

(4) Ensuring that all solicitations and contracts specify that on-site general and sub-contractor’s construction workers have completed at least 10 hours of Construction Safety training or the OSHA 30-hour Construction Safety training, and other relevant competency training, as determined by the CSO with input from the Multi-Disciplinary Team. The determination for other relevant competency training is based on the project hazards and complexity, Federal, and State regulations and VA requirements.

(5) Ensuring that all projects require contractor certification verifying completion of required training.

(6) Ensuring submittals for contract construction or renovation work to include the names, qualifications, and training dates for the contractor CP designated to administer the site-specific safety program, as well as the CP for other activities as required by OSHA regulation (such as scaffolds, cranes, excavations, etc.).

(7) Evaluating and considering past safety records of prospective contractors in awarding contracts. At a minimum, ensuring that all solicitations and contracts specify that contractors must not have more than three serious, or one repeat, or one willful OSHA violation(s) in the past 3 years or any significant environmental penalties.

Additionally, ensuring that all solicitations and contracts specify that contractors must have an Experience Modification Rate (EMR) of equal to or less than 1.0 (EMR of 1.0 indicates that a contractor had an average insurance claim’s rate for worker injuries)

(8) Serving on the facility Construction Safety Committee to ensure contracts meet the Committee’s requirements.

(9) Supporting the CSO, Facility Safety Manager, RE, and appropriate staff in implementing the construction safety program and enforcement of the contracts.

(10) Ensuring and maintaining record that, if contracted, construction worker(s) have been determined to be at risk for transmission of tuberculosis (TB) based upon the TB preconstruction risk assessment. The contractor must provide written certification that all contract employees assigned to the work site have had a pre-placement tuberculin screening within 90 days prior to assignment to the worksite and been found to be with negative screening reactions. This can be the Centers for Disease Control and Prevention (CDC) two-step skin testing or a Food and Drug Administration (FDA)-approved blood test. Employees manifesting positive screening reactions to the tuberculin must be examined, according to current CDC guidelines, prior to working on VHA property. Subsequently, if the employee is found without evidence of active (infectious) pulmonary TB, a statement documenting examination by a physician must be on file with the employer (construction contractor), noting that the employee with a positive tuberculin screening test is without evidence of active (infectious) pulmonary TB. If the employee is found with evidence of active (infectious) pulmonary TB, the employee would require treatment with a subsequent statement as outlined in subparagraph 4q (11)(c) before being allowed to return to work on VHA property.

(11) CORs are trained and designated as facility Construction Safety Officer(s)

(CSO).

g. Construction Safety Officer (CSO)

(1) Submitting project reviews of all construction projects.

(2) Providing oversight of contract construction safety.

(3) Being knowledgeable in the general inspection of typical work sites during construction and renovation performed by contract staff, and in the review of contractor safety program submittals. Note: CSO(s) do not take the place of the contractor’s CP nor act on their behalf. The CSO(s) determines if the contractor is meeting VA standards and contractual requirements for safety and OSHA compliance. When these standards and contract requirements are not being met, the VA Contracting Officer’s Representative (COR), CO, and CSC must take immediate action to prevent injury, exposure, non-compliance, and/or property damage.

(4) Ensuring that the specific safety requirements for construction operations are implemented during facility projects.

(5) Serving as a member of the Multi-Disciplinary Team.

(6) Conducting periodic inspections of VHA construction sites to ensure compliance with safety elements of the established program(s); at minimum, weekly inspections are required.

(7) Monitoring and inspecting construction and renovation work sites periodically to assure compliance with these policies.

(8) Maintaining competence in the general inspection of work sites during construction, renovation, and maintenance, falls under the purview of this policy.

(9) Approving corrective actions.

(10) Stopping unsafe work or activities that are non-compliant with the contract or OSHA and notifying the CO immediately.

(11) Maintaining communication with the contractor CP on questions of safety.

h. Facility Safety Program Manager

(1) Ensuring that VHA policy for the Construction Safety Program is implemented within the medical center.

(2) Chairing the Construction Safety Committee or assigning a designee to serve as the chair.

(3) Ensuring that necessary and relevant Interim Life Safety Measure (ILSM)s are established and implemented. Conducts required additional training for compliance with identified ILSMs.

(4) Rendering technical advice and assistance as required in connection with life safety and fire protection issues during construction, project design, and development.

(5) Overseeing compliance with OSHA and other relevant construction safety regulations.

(6) Confirming that VHSO staff receives training required by this memorandum.

(7) Ensuring that the Construction Safety Program includes appropriate periodic construction site hazard surveillance.

i. Infection Prevention Program Manager

(1) Advising and/or providing recommendations on exposure mitigation and the prevention of facility associated infections in patients, staff, and visitors.

(2) Coordinating with the manager of each construction project (in-house and contract) to conduct an Infection Control Risk Assessment (ICRA) during the planning and/or design stage of the work. ICRAs must be documented in writing and focus on eliminating, or minimizing, the risk of infection during construction and renovation activities.

(3) Monitoring infection prevention protocols during construction activities as indicated in ICRA for that project.

j. Green Environment Management System (GEMS) Coordinator

(1) Providing guidance on EPA regulations and environmental issues, as those regulations and issues directly and immediately relate to the safety during the design stage.

(2) Monitoring contractor compliance with contract specifications on Environmental Protection Agency (EPA) regulations, as those regulations directly and immediately relate to the construction project, including environmental compliance, pollution prevention, waste management, and permitting.

k. Emergency Program Coordinator

(1) Providing guidance on OSHA regulations as they apply to emergency planning, response, and operations in construction (i.e. 29 CFR 1926.35 and 29 CFR 1926.65).

(2) Monitoring contractor performance to contracted specifications on OSHA Regulations as they apply to emergency planning, response, and operations related to construction operations.

l. The Construction Safety Committee (Multi-Disciplinary Team)

(1) Determining the scope and depth of safety, infection control, emergency management, and security interventions appropriate for all construction work. The team may develop threshold criteria for each level of intervention. For instance, after review, some projects may require only CSO surveillance to ensure employee safety and OSHA compliance, while other projects will require all disciplines to be involved.

(2) Conducting preconstruction risk assessments for air quality requirements, infection control, utility requirements, noise, vibration, and other hazards that affect care, treatment, and services. Using the current American Institute of Architects (AIA) Guidelines, staff must conduct and document in writing preconstruction risk assessments during the design or planning stage of the work (prior to bidding, award, and starting work). Preconstruction risk assessments must focus on eliminating, or minimizing the above mentioned risks during construction and renovation activities. The complexity of the preconstruction risk assessment report is determined by the complexity of the threats posed by the construction project. Assigned VHA staff and CFM REs must confirm compliance during the construction phase of the work.

(3) Conducting a preconstruction risk assessment for the transmission of Mycobacterium Tuberculosis (TB) to the contracted construction workers based upon the construction site location, patient population, hospital layout, and the Centers for Disease and Prevention (CDC) defined risk as outlined in the “CDC Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Setting, 2005.”

(4) Ensuring ILSMs are assessed and implemented on all construction work in accordance with TJC Standards. ILSMs are required when Life Safety Code deficiencies or construction activities pose significant hazards as determined by the assessment. Each medical facility must have a local policy addressing ILSM as required by TJC.

(5) Participating in all phases of construction work from planning through completion. This includes review and approval of construction plans, contract specifications, and contract submittals related to construction safety and health and any other documents that may assist in the implementation of an effective Construction Safety Program. The Multi-Disciplinary Team must be involved early in the process and continue oversight on a regular basis to avoid costly and disruptive delays.

(6) Ensuring that the Construction Safety Program includes periodic construction site hazard surveillance activities with appropriate membership, scope, and frequency for each project as determined by the Construction Safety Officer and the preconstruction risk assessment. At a minimum, weekly surveillance activities are required. In some cases, daily inspections may be warranted. Hazard surveillance activities must be documented (date, time, members of the inspection team, deficiencies, type of corrective action, and time and date of correction). Correction of hazards must be tracked to completion.

(7) Ensuring all contractors entering VHA properties comply with the security management program. As a minimum, contractors must notify and obtain permission from the VA Police, be identified by project and employer, and be restricted from unauthorized access.

(8) Ensuring that all contractor employees have adequate documentation that they have no active tuberculosis.

(9) Evaluating the effectiveness of the Construction Safety Program in an annual report to the facility Safety Committee and/or Environment of Care Committee, or equivalent committee.

(10) Requiring the contractor CP to implement and maintain an effective Safety Program that identifies and controls hazards that may cause injury or illness to VA patients, staff, visitors, and contractor employees.

(11) Meeting at least monthly.

(12) Ensuring that documentation of the team’s inspections is provided to the Network Safety and Health Staff as requested.

m. VA Police

(1) Ensuring that all contractors entering VHSO property comply with the Security Management Program. At a minimum, contractors must notify and obtain permission of the VHSO Police, be identified by project and employer, and be restricted from unauthorized access.

(2) Conducting periodic surveillance of site security and the integrity of barriers for trenches and other hazards.

4. Intervention and Enforcement: All of the individuals with defined actions in this directive will intervene, whenever conditions, as a result of construction activities, immediately threaten life or health or threaten to damage equipment or buildings.

Intervention and enforcement of this Directive and the associated regulatory requirements are as follows:

a. Staff. All staff will identify hazardous conditions in need of intervention and further develop a culture of safety. CPs and all facility management will take prompt corrective measures to include immediate abatement of hazards, stopping of work, hazard awareness training, administrative controls, etc.

b. Contractors. The Construction Safety Officer or CO shall notify the contractor orally, with written confirmation, and request immediate initiation of corrective action of hazards identified. After receiving the notice, the Contractor shall immediately take corrective action. If the Contractor fails or refuses to promptly take corrective action, the CO may issue an order stopping all or part of the work until satisfactory corrective action has been taken (Federal Acquisition Regulations (FAR) 52.236-13). Upon a repeat offense of the same or substantially similar hazard, the Construction Safety Officer or CO should inform OSHA or other authorities (i.e., federal, state, or local officials) of the instances where the contractor has been notified to take immediate action to correct serious or imminent dangers (FAR 36.513). The Construction Safety Officer, with assistance from the Multi-Disciplinary Team, is responsible for making the Contractor and CO formally aware of hazards in need of correction. The CO is responsible for enforcement of the contract.

5. References: VHA Directive for Safety and Health during Construction.

6. Rescissions: Medical Center Memorandum (MCM) 12-00-88 dated May 22, 2012.

7. Rescission: MCM will expire on May 22, 2018.

5/18/2015

X Mark A. Worley, MD, PhD

Medical Center Director

Signed by: MARK A. WORLEY 144125

5/13/2015

X W. Keith Neeley, FACHE

Associate Medical Center Director

Signed by: Neeley, William K. (FAV)

5/17/2015

X John Krueger MD, MPH

Chief of Staff

Signed by: people

5/13/2015

X Amy S. Lesniewski, RN MS

Associate Director for Patient Care Services

Signed by: AMY S. LESNIEWSKI 162378

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