3c - Statement of Work_rev 1.pdf

PR #: 61200PR260031508

STATEMENT OF WORK

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STATEMENT OF WORK (SOW)

FOR

NFPA 1582 FIRE FIGHTER EXAM

1.0 GENERAL

1.1 BACKGROUND

The U.S. Coast Guard (USCG) Training Center (TRACEN) Petaluma Fire Department located at 599 Tomales Road, Petaluma, CA 94952, requires all firefighters to undergo comprehensive medical evaluations to ensure they are medically qualified to safely perform essential job functions. This Statement of Work (SOW) outlines the requirements for conducting physical examinations for fire department personnel in accordance with NFPA 1582: Standard on Comprehensive Occupational Medical Program for Fire Departments.

The resulting contract will be a fixed-price requirements contract. The services specified in the Schedule are based on estimated quantities and are not guaranteed purchases. The Government anticipates a minimum of four and a maximum of ten medical examinations per year; however, actual quantities may vary and will not serve as a basis for price adjustment.

The associated North American Industry Classification System (NAICS) code is 621111 Product Service Code Q403 – Medical Evaluation/Screening.

1.2 SCOPE

The contractor must provide annual and pre-placement physical examinations for designated fire department personnel. All examinations must comply with the latest edition of NFPA 1582. Contractor must ensure all clinical laboratory services are performed by a laboratory licensed through the U.S. Department of Health and Human Services (DHHS)

1.3 OBJECTIVE

Ensure all fire department personnel meet medical and physical standards required for duty.

Identify and document any medical conditions that may affect job performance or safety.

1.4 APPLICABLE DOCUMENTS

1.4.1 Reference Documents

The following documents may be helpful to the Contractor in performing the work described in this document:

• NFPA 1582: Standard on Comprehensive Occupational Medical program for fire departments.

• OSHA 29 CFR 1910 Regulations

2.0 SPECIFIC REQUIREMENTS/TASKS

Contractor must perform a physical examination of each employee. Document results on the NFPA Physical Exam Form 1582 or its equivalent ensuing all medical and laboratory information and results are included. Contractor must document all results to include all diagnostic tests, graphs, charts, reports, questionnaires, waivers, employee consent forms, physical findings, and examination results within 30 working days of completion of testing. The contractor must provide reports to the Base Fire Chief when reports are ready.

https://uscg.sharepoint-mil.us/sites/cg9/ARM/SCOPE%20PARAGRAPHS.doc

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Each examination must include each of the following components:

2.1 TASK ONE. PHYSICAL EXAMINATION COMPONENTS

• Vital Signs:

➢ Blood pressure

➢ Pulse rate and rhythm

➢ Respiratory rate

➢ Height, weight, and BMI

• Vision Examination:

➢ Visual acuity (near and far)

➢ Peripheral vision

➢ Color vision

➢ Depth perception

• Hearing Examination:

➢ Audiometric testing (pure-tone thresholds)

• Head, Eyes, Ears, Nose, Throat (HEENT):

➢ Inspection and palpation for abnormalities

• Neck and Thyroid:

➢ Palpation for masses, nodules, or enlargement

• Cardiovascular System:

➢ Heart rate and rhythm

➢ Heart sounds

➢ Peripheral pulses

➢ Repeat blood pressure if abnormal

• Respiratory System:

➢ Inspection, palpation, percussion, auscultation of lungs

• Gastrointestinal System:

➢ Inspection, palpation, percussion, auscultation of abdomen

➢ Assessment for hernias

• Genitourinary System:

➢ Examination as indicated (hernia, testicular exam, etc.)

• Musculoskeletal System:

➢ Range of motion

➢ Strength

➢ Joint stability

➢ Spine assessment

• Neurological System:

➢ Mental status

➢ Cranial nerves

➢ Motor and sensory function

➢ Reflexes

➢ Balance and coordination

• Skin:

➢ Inspection for lesions, rashes, or other abnormalities

• Lymphatic System:

➢ Palpation for lymphadenopathy

• Other:

➢ Review of immunization status

➢ Review of occupational history and exposures

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2.2 TASK TWO. CONTRACTOR RESPONSIBILITIES

• The contractor is responsible for providing all necessary materials, equipment, labor required to perform the physical examinations and any additional items not previously listed to provide successful firefighter physical examinations according to the NFPA 1582 requirements.

• The contractor must ensure all testing for designated personnel is completed within 30 calendar days from the date the first test is administered.

• The contractor must deliver all individual examination results and summary reports to the Base Fire Chief within 30 calendar days of completion of testing.

2.3 TASK THREE. DOCUMENTATION AND REPORTING

• Provide a detailed medical report for each examination, including findings and recommendations.

• Ensure secure storage and transmission of medical records in compliance with applicable privacy laws and regulations.

• Submit summary reports to the Base Fire Chief within 30 calendar days of completion of testing.

2.4 TASK FOUR. PERSONNEL QUALIFICATIONS

All examinations must be conducted by licensed healthcare providers with experience in occupational health and familiarity with NFPA 1582 standards. The contractor must provide an on-site supervisor or a point of contact that must be responsible for the quality control and performance of the work. This supervisor must be present at all times that contractor employees are on base, if applicable. Contractor must provide a Board eligible or Certified Occupational Medicine Physician to conduct job-related medical surveillance physical examinations and occupational health consultation services.

2.5 TASK FIVE. DELIVERABLES

• Individual physical examination reports

• Summary compliance report for the Base Fire Chief.

• Secure management of medical records

• HIPPA Information. In performing the services required hereunder, the contractor must only provide information to persons with a need to know to include: the firefighter, base fire chief, and/ or the contracting officer.

2.6 TASK FIVE. MEDICAL HISTORY QUESTIONNAIRE

Contractor must review an annual medical history questionnaire of new hires and current employees, which includes changes in health status and known occupational exposures since the previous annual evaluation Attachment 1 (Firefighter Health History)

2.7 TASK THREE. DOCUMENTATION AND REPORTING

Contractor must maintain strict confidentiality of all medical information and comply with all applicable federal, state, and local privacy regulations.

2.8 TASK THREE. PROTECTION OF PERSONALLY IDENTIFIABLE INFORMATION (PII)

The Contractor must protect all Personally Identifiable Information (PII) encountered, generated, processed, stored, transmitted, or otherwise handled in the performance of this contract. This requirement applies to PII in any form (electronic, paper, verbal) and includes PII provided by the Government, collected on behalf of the Government, or created as part of contract performance.

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If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor must bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

The Contractor must immediately (without unreasonable delay) notify the CO upon discovery or suspicion of any actual or suspected loss, compromise, or unauthorized access, use, disclosure, modification, or destruction of PII, whether in electronic, paper, or verbal form.

The Contractor must handle all PII in accordance with applicable federal statutes and policies (including, as applicable, the Privacy Act of 1974, the E-Government Act of 2002, FISMA, and OMB guidance on safeguarding and breach response), the Federal Acquisition Regulation (including FAR Subpart 24.1 and clause 52.224-3 Privacy Training (Jan 2017).

The Contractor must also comply with all other applicable state and local privacy and data security laws, to the extent such laws do not conflict with Federal law or explicit direction from the Contracting Officer. In the event of any conflict, Federal requirements and Contracting Officer direction must govern. The Contractor must immediately notify the Contracting Officer of any potential conflict between applicable state law and the requirements of this contract and must not take independent action (including breach notifications) without written direction from the Contracting Officer.

3.0 CONTRACTOR PERSONNEL

The Contractor must provide qualified personnel to perform all requirements specified in this SOW at all times. The contractor must not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest nor must the contractor employ any person who is an employee of the military or civilian.

3.1 QUALIFIED PERSONNEL

The Contractor must provide qualified personnel to perform all requirements specified in this SOW. The contractor must ensure all employees possess all required licenses for operating certified occupational medicine to conduct job-related medical surveillance physical examinations and occupational health consultation services. This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information. (NOTE: The Government does not provide training to contractors.

Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified, and otherwise qualified to provide services.)

3.2 CONTINUITY OF SUPPORT

The Contractor must ensure that the contractually required level of support for this requirement is maintained at all times. The Contractor must ensure that all contract support personnel are present for all hours of the workday. If for any reason the Contractor staffing levels are not maintained due to vacation, leave, appointments, etc., and replacement personnel will not be provided, the Contractor must provide e-mail notification to the Government Technical Representative prior to employee absence. Otherwise, the Contractor must provide a fully qualified replacement.

3.3 KEY PERSONNEL

Before replacing any individual designated as Key by the Government, the Contractor must notify the Contracting Officer no less than 15 business days in advance, submit written justification for replacement, and provide the name and qualifications of any proposed substitute(s). All proposed substitutes must possess qualifications equal to or superior to those

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of the Key person being replaced, unless otherwise approved by the Contracting Officer. The Contractor must not replace Key Contractor personnel without approval from the Contracting Officer. The following Contractor personnel are designated as Key for this requirement. Note:

The Government may designate additional Contractor personnel as Key at the time of award.

Licensed healthcare providers with experience in occupational health and familiarity with NFPA 1582 standards.

3.3.1 Contractor Key personnel must not be assigned by the Contractor to more than one key position for this requirement.

3.5 EMPLOYEE IDENTIFICATION

3.5.1 Contractor employees visiting Government facilities must wear an identification badge that, at a minimum, displays the Contractor name, the employee’s photo, name, clearance-level and badge expiration date. Visiting Contractor employees must comply with all Government escort rules and requirements. All Contractor employees must identify themselves as Contractors when their status is not readily apparent and display all identification and visitor badges in plain view above the waist at all times.

3.5.2 Contractor employees working on-site at Government facilities must wear a Government issued identification badge. All Contractor employees must identify themselves as Contractors when their status is not readily apparent (in meetings, when answering Government telephones, in e-mail messages, etc.) and display the Government issued badge in plain view above the waist at all times.

3.6 EMPLOYEE CONDUCT

Contractor’s employees must comply with all applicable Government regulations, policies and procedures (e.g., fire, safety, sanitation, environmental protection, security, “off limits” areas, wearing of parts of DHS uniforms, and possession of weapons) when visiting or working at Government facilities. The Contractor must ensure Contractor employees present a professional appearance at all times and that their conduct must not reflect discredit on the United States or the Department of Homeland Security. The Project Manager must ensure Contractor employees understand and abide by Department of Homeland Security established rules, regulations and policies concerning safety and security.

3.7 REMOVING EMPLOYEES FOR MISCONDUCT OR SECURITY REASONS

The Government may, at its sole discretion (via the Contracting Officer), direct the Contractor to remove any Contractor employee from DHS facilities for misconduct or security reasons.

Removal does not relieve the Contractor of the responsibility to continue providing the services required under the contract. The Contracting Officer will provide the Contractor with a written explanation to support any request to remove an employee.

4.0 OTHER APPLICABLE CONDITIONS

4.1 SECURITY

Contractor access to unclassified, but Security Sensitive Information may be required under this SOW. Contractor employees must safeguard this information against unauthorized disclosure or dissemination.

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4.2 PERIOD OF PERFORMANCE

The period of performance for this contract is a one-year base period with four one-year option periods as follows:

Base Period August 1, 2026 to July 31, 2027 Option Period One August 1, 2027 to July 31, 2028 Option Period Two August 1, 2028 to July 31, 2029 Option Period Three August 1, 2029 to July 31, 2030 Option Period Four August 1, 2030 to July 31, 2031

Services must be provided annually. All examinations for a given group must be completed within 30 calendar days from the first test date. All results and reports must be delivered within 30 calendar days of completion of testing.

4.3 PLACE OF PERFORMANCE

The primary place of performance will be the Contractors medical facility.

4.4 HOURS OF OPERATION

Contractor employees must generally perform all work between the hours of 0730 and 1630 PST, Monday through Friday (except Federal holidays). However, there may be occasions when Contractor employees must be required to work other than normal business hours, including weekends and holidays, to fulfill requirements under this SOW.

4.5 TRAVEL

Contractor travel will not be required for the performance of this contract.

4.5.1 Coast Guard personnel are prepared to travel up to a 20-mile radius from the U.S. Coast Guard Training Center (TRACEN) Petaluma, located at 599 Tomales Rd, Petaluma, CA 94952, to the Contractor's facility to receive services.

4.6 GENERAL REPORT REQUIREMENTS

The Contractor must provide all written reports in electronic format with read/write capability using applications that are compatible with DHS workstations (Microsoft Office Applications).

5.0 GOVERNMENT FURNISHED RESOURCES

The Government will not furnish any resources to the Contractor in support of this contract.

6.0 CONTRACTOR FURNISHED PROPERTY

The Contractor must furnish, materials, equipment and services necessary to fulfill the requirements of this contract, except for the Government Furnished Resources specified in SOW 2.0 and SOW 5.0.

7.0 GOVERNMENT ACCEPTANCE PERIOD

The Government Technical Representative will review deliverables prior to acceptance and provide the contractor with an e-mail that provides documented reasons for non-acceptance. If the deliverable is acceptable, the Government Technical Representative will send an e-mail to the Contractor notifying it that the deliverable has been accepted.

7.1 The Government Technical Representative will have the right to reject or require correction of any deficiencies found in the deliverables that are contrary to the information contained in the

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Contractor’s accepted proposal. In the event of a rejected deliverable, the Contractor will be notified in writing by the Government Technical Representative of the specific reasons for rejection. The Contractor may have an opportunity to correct the rejected deliverable and return it per delivery instructions.

7.2 The Government Technical Representative will have 10 business days to review deliverables and make comments. The Contractor must have 10 business days to make corrections and redeliver.

7.3 All other review times and schedules for deliverables must be agreed upon by the parties based on the final approved Project Plan. The Contractor must be responsible for timely delivery to Government personnel in the agreed upon review chain, at each stage of the review.

The Contractor must work with personnel reviewing the deliverables to assure that the established schedule is maintained.

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