80LARC20Q0001 RFQOccupationalHealthServices.pdf

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Subject: Critical Incident Stress Management (CISM) Program

Responsible Office: Safety & Mission Assurance Office

TABLE OF CONTENTS

PREFACE

P.1 Purpose……………………………………………………………………………………………….3

P.2 Applicability…………………………………………………………………………………………...3

P.3 Authority……………………………………………………………………………………………

P.4 Applicable Documents and Forms…………………………………………………………………3

P.5 Measurement/Verification…………………………………………………………………………...3

P.6 Cancellation…………………………………………………………………………………………..3

CHAPTER 1. INTRODUCTION……………………………………………………………….4

CHAPTER 2. CORE COMPONENTS

2.1 Pre-Incident preparation

2.2 Disaster, terrorist, or other large scale incident interventions

2.3 Defusing

2.4 Critical Incident Stress Debriefing (CISD)

2.5 One-on-one Crisis Intervention/Counseling

2.6 Referral mechanisms for assessment and follow on treatment

CHAPTER 3 RESPONSIBILITY……………………………………………………………….6

3.1 Critical Incident Stress Management (CISM) Team

3.2 Responsibilities

LPR 1830.2C

Effective Date: October 19, 2017

Expiration Date: October 31, 2022

Langley Procedural Requirement

October 19, 2017 LPR 1830.2.C

Verify the correct version before use by checking the LMS Website.

CHAPTER 4 RECORDS…………………………………………………………………………………8

APPENDIX A – DEFINITIONS

APPENDIX B - ACRONYMS

PREFACE

P.1 PURPOSE

The purpose of the Critical Incident Stress Management (CISM) program is to provide employees at NASA Langley Research Center with support when there is an occurrence that causes a significant stress reaction that overwhelms the employees’ ability to adjust emotionally.

P.2 APPLICABILITY

This LPR is applicable to all NASA personnel involved in a critical incident.

P.3 AUTHORITY

NPR 1800.1, “NASA Occupational Health Program Procedures.”

P.4 APPLICABLE DOCUMENTS AND FORMS

NPR 1800.1, “NASA Occupational Health Program Procedures.”

P.5 MEASUREMENT/VERIFICATION

The Agency Office of the Chief Health and Medical Officer conducts an audit every 3 years and LaRC develops a self-assessment report annually.

P.6 CANCELLATION

LPR 1830.2, Critical Incident Stress Management (CISM) Program at NASA Langley Research Center dated March 13, 2007.

Clayton P. Turner Deputy Director

DISTRIBUTION

Approved for public release via the Langley Management System; distribution is unlimited.

CHAPTER 1. INTRODUCTION

1.1 This LPR establishes a procedure for delivery of stress management services through a team coordinated by the LaRC’s Occupational Health Officer (OHO), the Center Medical Officer (CMO) and Center Health Clinic Administrator and outlines the responsibilities of Center Management, the Employee Assistance Program (EAP) Coordinator, CISM team members, Office of Human Capital personnel, and supervisors. This plan describes the procedures to be followed in providing CISM services immediately following an emergency situation, delegates specific responsibilities, outlines preparatory measures to be taken in advance, provides for the psychological care and support of victims and their families, and measures to assist with bringing about the orderly return of the workplace to a normal mode of operation.

1.2 These critical incidents that could occur at home or within the work place include, but are not limited to:

a. suicides,

b. assaults and threats,

c. homicide in the workplace,

d. situations attracting undue and/or critical media attention,

e. serious workplace accidents,

f. vehicle accidents,

g. natural or man-made disasters,

h. terrorism,

i. major mission failure,

j. domestic violence, and

k. loss or death in workplace.

CHAPTER 2. CORE COMPONENTS

CISM includes six core components that are comprehensive in scope and span the entire temporal spectrum of a crisis.

2.1 Pre-Incident preparation

2.1.1 Pre-incident training helps employees prepare to cope with traumatic events and incidents. People who are forewarned about traumatic stress are better able to manage it and recognize its signs earlier.

2.1.2 Training designed to: (1) teach effective approaches to dealing with traumatic stress; (2) avoid ineffective approaches; and (3) emphasize that it is normal to feel stress in abnormal situations, shall be included as part of new supervisor orientation and organizational briefings provided by the EAP Coordinator at staff meetings, all-hands meetings, lunch/learns and other appropriate venues. Trainings shall include best practices and procedures in dealing with critical incidents identified in 1.2.

2.2 Disaster, terrorist, or other large scale incident interventions

2.2.1 Employee Assistance Program (EAP) services shall be offered by NASA LaRC management at the 24 Hour EAP Call Center.

2.2.2 EAP Call Center employees shall assist in contacting EAP providers who shall in turn assist local leadership in Critical Incident Stress Debriefing (CISD) activities.

2.2.3 Once notified of a critical incident, the EAP Coordinator shall:

a. Assemble and notify the CISD team and any appropriate community partners when there is a need for intervention/support.

b. Lead the CISD team in providing defusing and debriefings and, as needed, provide one-on-one interventions, referral, and follow-up services.

2.3 Defusing

2.3.1 EAP providers shall offer one-on-one or small group discussions in the immediate post-event phase.

2.3.2 Based on an employee(s) desire for discussion, the employee(s) shall receive education about recognition of stress symptoms and management strategies for coping with stress. These techniques are used for limited-scope events or when only a small number of employees are affected.

2.4 Critical Incident Stress Debriefing (CISD)

2.4.1 CISD team members participate in initial assessments and post-incident intervention planning.

2.4.2 Team members provide defusing and debriefing services under the direction of the EAP Coordinator and assist in identifying individuals in need of additional EAP services. Upon completion of CISD services, those team members who provided the services shall be debriefed themselves by other team members.

2.4.3 Team members or the EAP Coordinator assist in follow up monitoring of adversely affected employees as requested or appropriate. The EAP Coordinator provides guidance with all follow-up activities.

2.5 One-on-one Crisis Intervention/Counseling

2.5.1 Psychological support for employees and family members shall be offered throughout the crisis spectrum.

2.5.2 The EAP provider shall be informed by the Occupational Health Officer of personnel who are assisting in major Center or agency-wide incident mitigation or recovery efforts.

2.5.3 Supervisors are responsible for encouraging and granting time for employees to participate in officially sanctioned CISM services. The supervisor should contact EAP directly if he/she is concerned that an employee is in need of additional assistance.

2.6 Referral mechanisms for assessment and follow on treatment

2.6.1 EAP shall maintain a list of resources for referral and 24-hour support shall be available throughout the incident and aftercare.

2.6.2 A general after action report on critical incident services shall be prepared by the EAP provider for review by the LaRC Medical Director and/or Center Health Clinic Administrator for review by the CISM team’s review for lessons learned and process improvement at the next CISM team meeting.

CHAPTER 3. RESPONSIBILITY

3.1 Critical Incident Stress Management (CISM) Team

3.1.1 The CISM team shall include the following:

a. Center Medical Officer or his/her designee,

b. Occupational Health Officer,

c. Center Health Clinic Administrator,

d. Employee/Labor relations representative,

e. Office of Chief Counsel legal advisor,

f. Employee Assistance Program (EAP) mental health professionals,

g. Security and Program Protection Branch representative,

h. Office of Safety and Mission Assurance representative – Emergency Manager, and

i. Managers or supervisors as appropriate for review of critical incidents and to help determine appropriate members for the Critical Incident Stress Debriefing Team.

3.1.2 The CISM team shall determine what services are needed, when the support shall be provided, and how the services are to be delivered.

3.1.3 The CISM team shall review this LPR against the NPR every two years for any required updates. If no changes are required, it shall be noted in CISM meeting minutes.

3.1.4 Critical Incident Stress Debriefing Team:

3.1.4.1 The EAP, in coordination with CISM, determines needed CISD team members, who are expected to:

a. respect confidentiality,

b. have good interpersonal skills, and

c. react quickly when called.

3.1.4.2 CISD team members shall be responsible for:

a. maintaining familiarization with CISD components,

b. maintaining intervention skills through participation in team building and planning meetings once initial training is completed,

c. knowing and adhering to CISD procedures and protocol,

d. providing CISM support following a critical incident whenever possible, and

e. taking guidance and direction from the EAP.

3.1.4.3 Mental health providers from the outside community shall also be included as needed for support of non-NASA individuals.

3.1.4.4 The EAP Coordinator shall serve as CISM team lead. Team members are expected to make a two-year commitment to the team once trained.

3.2 Responsibilities

3.2.1 The Critical Incident Stress Management Program at Langley Research Center will be responsible for:

a. developing and coordinating the Center response plan,

b. conducting and coordinating debriefing,

c. conducting training,

d. consulting with management,

e. mobilizing support services both within the Center and in the community at large, assessing the Center’s response to the crisis, and

f. adjusting the response as warranted and being flexible, available, and accessible.

3.2.3 The EAP Provider shall:

a. develop CISM procedures,

b. train and maintain a CISD team,

c. provide direction and coordination of that team,

d. ensure proper assessment, triage, treatment, referral, and follow up for employees adversely affected for up to one year post-incident, and

e. provide promotion and education about the plan to Center management, supervisors, and employees.

3.2.4 Center managers and supervisors are responsible for:

a. notifying the EAP Provider of any critical incidents,

b. assisting in identification of individuals and groups adversely affected by the event,

c. providing incident information that will facilitate the debriefing process, and

d. allowing and encouraging employees to participate in post-incident defusing and debriefings.

3.2.6 The Office of Human Capital Management is responsible for providing guidance and assistance on how to handle employee problems.

3.2.6.1 Members of the CISM shall notify the EAP Provider, by phone, of critical incidents, assist in identifying individuals and groups adversely affected by the event and inform supervisors of availability of CISM services.

3.2.7 The NASA Shared Services Center shall provide services to victims following an incident (insurance, death benefits, workers compensation claims, etc.).

Chapter 4. RECORDS

4.1 Critical incident stress debriefings are considered confidential discussions under EAP. All records must be kept in compliance with NPR 1800.1, paragraph 5.7.9. Team members shall not make personal notes or records outside of required EAP records.

4.2 The EAP Provider shall maintain an up-to-date list of trained CISD team members and contact information

4.3 The Center Health Clinic Administrator will maintain minutes of the CISM meetings to maintain a record of collaboration among center offices in CISM process improvements and lessons learned.

APPENDIX A – DEFINITIONS

A.1 Critical Incident: The recognized definition of a critical incident is quite broad.

A critical incident is defined as any event outside of the usual realm of daily human experience that is markedly distressing and has the potential to interfere with an individual’s ability to function, either at the scene or at a later time.

A.2 Critical Incident Stress Debriefing: Critical Incident Stress Debriefing is a structured group discussion, conducted soon after a traumatic event, (24 hours or less after an event) led by trained personnel intended to assist employees who have experienced a critical incident. Its purpose is to mitigate the adverse psychological reaction resulting from a traumatic experience. The process supports recovery by providing group support and linking participants to counseling and treatment services if they become necessary.

A.3 Critical Incident Stress Defusing: Critical Incident Stress Defusing is a small group process that typically takes no more than 30 minutes. The purpose is to try to rapidly reduce the intense reaction to a traumatic event, “normalize” the experience so that employees can return to routine duties as quickly as possible, provide information on acute stress and how to reduce it, and to determine if a full debriefing should be scheduled.

A.4 Critical Incident Stress Management: Critical Incident Stress Management is a process that includes pre-crisis preparation, stress education, and intervention designed to help employees recover more quickly from abnormally stressful events.

APPENDIX B - ACRONYMS

CISD Critical Incident Stress Debriefing

CISM

CMO

EAP

OHO

Critical Incident Stress Management

Center Medical Officer

Employee Assistance Program

Occupational Health Officer

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LPR 1800.3C

Effective Date: April 6, 2018

Expiration Date: April 30, 2023

Subject: Bloodborne Pathogens

Responsible Office: Safety & Mission Assurance Office

TABLE OF CONTENTS

PREFACE………………………...……………………………………………………………

P.1 PURPOSE

P.2 APPLICABILITY

P.3 AUTHORITY

P.4 APPLICABLE DOCUMENTS AND FORMS

P.5 MEASUREMENT/VERIFICATION

P.6 CANCELLATION

1. PROGRAM ADMINISTRATION

1.1 CENTER DIRECTOR

1.2 CENTER’S OCCUPATIONAL HEALTH OFFICER

1.3 SUPERVISORS AND MANAGERS

1.4 EMPLOYEES

1.5 OCCUPATIONAL HEALTH CLINIC

1.6 CONTRACTING OFFICER'S REPRESENTATIVE /OCCUPATIONAL HEALTH OFFICER

2. EXPOSURE CONTROL PLAN

3. POST EXPOSURE MANAGEMENT

APPENDIX A: DEFINITIONS

Requirements

April 6, 2018 LPR 1800.3C

Verify the correct version before use by checking the LMS website.

a. Langley Research Center (LaRC) is committed to providing a safe and healthy work environment for all of its employees. In pursuit of this goal, the following plan is provided to eliminate or minimize occupational exposure to bloodborne pathogens (BBP) in accordance with OSHA standard 29 CFR 1910.1030, “Occupational Exposure to Bloodborne Pathogens.”

b. Given that NASA LaRC has a level of occupational exposure different from a traditional healthcare environment (the intent of the entire OSHA standard), the scope of this requirement addresses the unique needs of this Center. This applies to the occupational exposure of responders to workplace emergencies and incidents where the involvement of employees in the response is rendered only as a collateral duty.

c. The workplace environment of some employees involves occupational exposures that are not collateral, which means that they render assistance on a regular basis (i.e., occupational health professionals).

(1) When employees have occupational exposures that are not collateral, their organization of assignment must develop additional procedures to address unique exposures.

(2) Category I and II employees, as identified in the Exposure Control Plan within this document, who are reasonably expected to come in contact with blood or other potentially infectious materials, will be provided training according to OSHA standards, and shall be offered Hepatitis B vaccination series at no cost to the employee. The Hepatitis B vaccination series is available to employees who have been identified as at risk for occupational exposure, within the first 10 days of initial work assignment. If declined by the employee, the Hepatitis vaccination series will still be offered to them at any time upon request and at least during each subsequent protocol/surveillance examination.

d. The purpose of this Exposure Control Plan is to assist the Center in implementing and ensuring compliance with established standards designed to protect employees from serious injuries or illnesses caused by occupational exposure to BBP.

This document addresses:

(1) Explanations/definitions of terms

(2) Responsibilities

(3) Exposure incidents

(4) Recordkeeping

(5) Training/communications

P.2 APPLICABILITY

This requirement is applicable to all on-site employees: civil service, military, contractor, NASA exchange personnel, grantees, and research associates.

P.3 AUTHORITY

a. 29 CFR 1910.1030, “Occupational Exposure to Bloodborne Pathogens.”

b. NPD 1800.2 “NASA Occupational Health Program.”

c. 29 CFR 1904 “Record Keeping”

P.4 APPLICABLE DOCUMENTS AND FORMS

a. NPR 1800.1D, “NASA Occupational Health Program Procedures.”

b. LPR 1845.1, “Automated External Defibrillator Program.”

c. LF 8, “Exposure Report Form.”

d. LF 53, “Hepatitis B Vaccination Consent/Documentation/Declination Form.”

P.5 MEASUREMENT/VERIFICATION

Verification of compliance with these requirements is accomplished through an annual review of the plan by the Medical Director and the COR or designee.

P.6 CANCELLATION

LPR 1800.2, dated March 7, 2008 LPR 1800.2, dated February 11, 2013

/s/ Clayton Turner April 6, 2018 Center Deputy Director Date

DISTRIBUTION:

1. PROGRAM ADMINISTRATION

1.1 Center Director

1.1.1 The chain of responsibility for ensuring that there is a safe work environment at NASA LaRC starts with the Center Director and flows downward through management and supervisors to the employees.

1.2 Center’s Occupational Health Officer, a function of the Safety Mission Assurance Office

1.2.1 The Center’s Occupational Health Officer (OHO) in consultation with Center Medical Director (CMD) will be responsible for implementing this program. He/she will maintain, review, and update the plan whenever necessary to include new or modified tasks and procedures.

1.2.2 The OHO shall ensure that all medical actions required under this program are performed and that appropriate employee health and OSHA records are maintained in a secure location.

1.3 Supervisors and Managers

1.3.1 Supervisors and managers shall be responsible for implementing applicable regulations, thereby enhancing a safe work environment under their control. It is their responsibility to provide resources and direction for compliance with OSHA regulations and this plan.

1.3.2 Essential functions include:

a. Referring employees with occupational exposures to BBP to the Occupational Health Clinic for evaluation and consultation.

b. Performing and coordinating required investigations of exposure incidents, using LF 8, “Exposure Report Form.”

c. Ensuring employees who may incur occupational exposure to blood or Other Potential Infectious Materials (OPIM) attend annual and supplemental training in Universal Precautions and BBP, as per 29 CFR 1910.1030, to include:

(1) How to access both 29 CFR 1910.1030 “Occupational Exposure to Bloodborne Pathogens”, and this LRP which includes LaRC’s exposure control plan.

(2) A general explanation of the epidemiology and symptoms of bloodborne diseases and how they are transmitted.

(3) An explanation of what constitutes an exposure incident.

(4) How to recognize tasks and other activities that may involve exposure to BBPs or OPIMs.

(5) An explanation of the types, proper uses, limitations, locations, removal, handling, decontamination, and disposal of Personal Protective Equipment (PPE).

(6) Information on the hepatitis B vaccine, its efficacy, safety, method of administration, benefits, and it is offered free of charge to employees who may incur occupational exposure to blood or OPIM.

(7) Information on the appropriate actions to take, and persons to contact in an emergency involving blood or OPIM.

(8) Information on procedures to follow if exposure occurs to include post exposure evaluation and follow up as explained in Chapter 3 of this LPR.

(9) An explanation of signs/symbols and color coding as required in 29 CFR 1910.1030.

(10) An opportunity for interactive questions and answers with the trainer during the training session.

e. Training records shall be completed for each employee after training. These records are kept for a minimum of three (3) years by the employer and include the dates of the training sessions; the contents or a summary of the training sessions; the names and qualifications of trainers; and the names and job titles of all persons attending the training sessions.

1.4 Category I and Category II employees (see descriptions in Chapter 2)

1.4.1. Employees are responsible for conducting tasks and procedures in a manner that minimizes risk to themselves and others.

1.4.2. All Category I and Category II employees shall:

a. Attend BBP training.

b. Use caution when assisting injured individuals to prevent contact with the injured individual’s blood or body fluids.

c. Report mishaps to the immediate supervisor and Center emergency response personnel. Do not clean up areas that have been contaminated with blood or other body fluids, as they will be cleaned by properly trained staff. If exposure to blood or other potentially infectious material (OPIM) occurs, seek medical care and evaluation at the Occupational Health Clinic.

d. Adhere to engineering and work practice controls.

e. Use available PPE, observing the following precautions:

(1) Remove PPE after it becomes contaminated and before leaving the work area.

(2) Used PPE will be disposed of by transferring it to emergency medical service (EMS) personnel upon their arrival at the scene. PPE will not be disposed of in standard trash receptacles.

(3) If available, wear protective gloves if hand contact with blood or OPIM is reasonably anticipated, and when handling or touching contaminated items or surfaces. Replace gloves if torn, punctured, or contaminated, or when their ability to function as a barrier is compromised.

(4) Wash hands immediately or as soon as feasible after removing gloves or other PPE.

(5) Never wash or decontaminate disposable gloves for reuse.

(6) When available, use CPR shields/masks with a one-way barrier device when providing rescue breathing.

(7) Remove immediately or as soon as feasible any garment contaminated by blood or OPIM, in such a way as to avoid contact with the contaminated surface.

(8) Any waste product with blood or OPIM shall be transferred to EMS when they arrive to transport a victim. Labeling of infectious waste generated at the scene will be conducted by EMS as part of the transfer procedure.

(9) Any personal garments contaminated with blood or OPIM must be laundered by a service that is certified to handle such items.

1.5 Occupational Health Clinic

1.5.1 The Occupational Health Clinic staff shall advise LaRC management on matters concerning BBP, and provide medical management support during exposure incidents.

1.5.2 Occupational Health Clinic shall:

a. Provide medical support to employees who experience occupational exposure to BBP. Appropriate post-exposure evaluation, prophylaxis, and follow-up will be provided. When requested, confidential psychological counseling is available to government employees through the Employee Assistance Program. The Hepatitis B vaccine shall be offered (within a reasonable time) to all government employees who are unvaccinated first aid responders (i.e. AED/CPR) and who render assistance in any situation involving the presence of blood or OPIM, regardless of whether an actual “exposure incident” occurred. LF 53 shall be filled out on each person offered Hepatitis B vaccine and kept with medical records.

b. Assist in investigating/managing exposure incidents and reporting findings to LaRC management and agencies as required.

c. Maintain medical records:

(1) Medical records are maintained for each employee with an occupational exposure in accordance with 29 CFR 1910.1020, “Access to Employee Exposure and Medical Records.” A written statement that the exposed employee has been informed of the results of the evaluation and about any exposure-related condition that requires additional assessment and treatment will be provided to the employee.

(2) These confidential records shall be retained for 30 years post-employment.

(3) A copy of an employee’s medical record shall be provided to the employee or a designated recipient upon written consent from the employee within 15 working days.

(4) Requests for copies of employee medical records must be sent to the Occupational Health Clinic, Building 1216, Mail Stop 409.

(5) The Office of Chief Counsel shall be consulted regarding content, disclosure, and release of medical records.

d. Transfer relevant medical records to health care provider(s) designated by an exposed person with written consent.

e. Provide initial evaluation and first aid treatment of contractors. Contractors who perform tasks that may result in an occupational exposure shall comply with their employer’s BBP Exposure Control Plan. After an “exposure incident,” contractor personnel are authorized to have an initial evaluation and first aid treatment at the Occupational Health Clinic. Contractors shall be assisted in obtaining follow up evaluation and treatment by an outside provider or facility if required.

f. Provide confidential medical evaluations and follow-up care for civil servants:

(1) Document the routes of exposure and how the exposure occurred.

(2) Identify and document information about an individual(s) who may be the source of an exposure (source individual) unless identification is infeasible or prohibited by state or local law.

(3) Obtain consent and make arrangements to have the source individual tested as soon as possible to determine HIV, HCV and HBV infectivity; document that the source individual’s test results were conveyed to the employee’s health care provider. If the source individual is already known to be HIV, HCV, and/or HBV positive, new testing is not performed.

(4) Assure that an exposed employee is provided with the source individual’s test results and with information about applicable disclosure laws and regulations concerning the identity and infectious status of the source individual (e.g., laws protecting confidentiality).

(5) After obtaining consent, collect an exposed employee’s blood as soon as feasible after an exposure incident, and test for HBV and HIV serological status.

(6) If an employee refuses HIV serological testing during collection of blood for baseline testing, preserve the baseline blood sample for at least 90 days. If the employee changes his/her mind and elects to have the baseline sample tested during this waiting period, perform testing as soon as feasible.

g. Evaluate all exposure incidents to determine if the case meets OSHA’s recordkeeping requirements (29 CFR 1904). At a minimum, an electronic NASA Langley Form 95 via Incident Reporting Information System shall be completed when a recordable injury results from an accident/incident or exposure to BBP occurs and:

(1) Is a work-related injury that involves loss of consciousness, transfer to another job, change in working conditions or duty restrictions or

(2) Results in a recommendation for medical treatment beyond first aid (for example, gamma globulin, Hepatitis B immune globulin, Hepatitis B vaccine, etc) regardless of dosage, or

(3) Results in a disease process.

1.6 Contracting Officer’s Representative/Occupational Health Officer/Center Medical Director

1.6.1. The Occupational Health Officer is responsible for the implementation of this plan, providing oversight to the Occupational Health Clinic, and serving as a resource on bloodborne pathogen issues.

1.6.2. The Occupational Health Officer and Center Medical Director:

a. Advises and assists, on request, organizations in the development of their BBP exposure control plan.

b. Provides health care professional(s), after an exposure incident, with the following:

(1) A description of the employee’s job duties relevant to the exposure incident.

(2) Route(s) of exposure.

(3) Circumstances of exposure.

(4) If possible, results of source individual blood test.

(5) Relevant employee medical records, including vaccination status.

c. Provides an affected employee with a copy of the evaluating health care professional’s written opinion within 15 days after completion of the evaluation.

d. Reviews the circumstances of all exposure incidents to determine:

(1) Engineering controls in use at the time (if applicable).

(2) Work practices followed.

(3) A description of the device being used (tool, machinery, AED, etc.).

(4) Protective equipment or clothing that was used at the time of exposure incident (gloves, CPR shields/masks, etc.).

(5) Disposition of contaminated PPE and garments.

(6) Location of the incident (office, parking lot, cafeteria, shop, etc.)

(7) Procedure being performed when the incident occurred (performing CPR, rendering wound care, etc.).

(8) Employee’s documented training (first aid, CPR, AED, etc.).

e. Ensures that appropriate changes are made to this plan.

(1) Changes may include an evaluation of safer devices, implementation of revised OSHA guidelines, changes in work practices, etc.

(2) Annual review and update of this plan, or more frequently, to reflect any new or modified tasks and procedures that affect occupational exposure.

2. Exposure Control Plan

2.1 OSHA requires employers to perform an exposure determination of all employees who may incur occupational exposure to blood or OPIM. The exposure determination is made without regard to the use of PPE (employees are considered to be exposed even when they wear PPE). Employees are designated as category I or II according to risk of exposure to blood or OPIM by their supervisor. Category I and II employees shall be offered Hepatitis B vaccination series with 10 working days of initial work assignment. Employees shall be given a declination LF 53 by Occupational Health Clinic licensed nurse. The Employee may request antibody testing.

2.1.1 Category I - All employees in the following job classifications are reasonably anticipated to have occupational exposure.

a. Medical Technologists

b. Nurses

c. Health Care Providers

d. Contractor Spill Response Team

2.1.2 Category II - Job classifications in which some employees may have occupational exposure.

a. Childcare Workers

2.2 Organizations required to have site/task specific plans include;

a. Occupational Health Clinic,

b. LaRC Exchange Child Development Center,

c. Contractor for the Spill Response team.

3. Post-Exposure Management

a. In the event of any known or suspected occupational exposure to blood or potentially infectious materials, the exposed employee must report promptly to a supervisor and the LaRC Occupational Health Clinic for medical aid and consultation.

After regular work hours, the employee will call 911 from any Center telephone or 864- 2222 from a cellular telephone (LaRC Dispatch Office) for appropriate first aid and decontamination, or assistance in reporting to a local hospital emergency room and report to the LaRC Occupational Health Clinic upon reporting for duty on the next regular work day. The scene may be preserved, if appropriate, for accident investigation, while preventing subsequent exposure risk.

b. The supervisor is responsible for ensuring the exposed employee receives all appropriate medical care, investigating the incident, and taking immediate and ultimate corrective actions.

c. If the source individual is known or can be identified, it is appropriate for the supervisor to suggest that the individual report to the LaRC Occupational Health Clinic for consultation/treatment, without discussion of blood testing. These proceedings should be documented; however, the source individual may not be named in the record without written consent.

e. It is the supervisor’s responsibility to enable the employee(s) to schedule and attend convenient appointments for consultation, treatment, and counseling.

f. An immediately available confidential medical evaluation and follow-up shall be conducted by the Center Occupational Health Clinic. Following initial first aid (clean the wound, flush eyes or other mucous membrane, etc.), the following activities shall be performed:

(1) Document the routes of exposure and how the exposure occurred.

(2) Identify and document the source individual (unless the employer can establish that identification is infeasible or prohibited by state or local law).

(3) Obtain consent and arrange to have the source individual tested as soon as possible to determine HIV, HCV, and HBV infectivity; document that the source individual’s test results were conveyed to the employee’s health care provider.

(4) Test the source individual for HIV, HCV, and/or HBV, unless already known.

(5) Assure that the exposed employee is provided with the source individual’s test results and with information about applicable disclosure laws and regulations concerning the identity and infectious status of the source individual (e.g., laws protecting confidentiality).

(6) Collect exposed employee’s blood, after obtaining consent, as soon as feasible after exposure incident, and test blood for HBV and HIV serological status.

(7) Preserve the baseline blood sample for at least 90 days if the employee refuses HIV serological testing during the collection of blood; if the exposed employee elects to have the baseline sample tested during this waiting period, perform testing as soon as feasible.

(8) Recommend and offer follow-up testing at three (3), six (6), and twelve (12) months after incident. Subsequent follow-up shall be offered in accordance with current and/or newly implemented recommendations of the CDC, OSHA, and the LaRC Occupational Health Clinic Medical Director.

g. The Occupational Health Officer and Medical Director shall ensure that health care professional(s) responsible for employee’s Hepatitis B vaccination and post-exposure evaluation and follow-up are given a copy of OSHA’s BBP standard.

h. The Medical Director shall ensure that the health care professional evaluating an employee after an exposure incident receives the following:

(1) A description of the employee’s job duties relevant to the exposure incident.

(2) Route(s) of exposure.

(3) Circumstance of exposure.

(4) If possible, results of the source individual’s blood test.

(5) Relevant employee medical records, including vaccination status.

i. The employee receives a copy of the evaluating health care professional’s written opinion within 15 days after completion of the evaluation.

j. The Occupational Health Officer and Medical Director shall review the circumstances of all exposure incidents to determine:

(1) Engineering controls in use at the time (if applicable).

(2) Work practices followed.

(3) A description of the device being used (including type and brand).

(4) Protective equipment or clothing that was used at the time of the exposure incident (gloves, CPR masks, etc.).

(5) Disposition of contaminated PPE.

(6) Location of the incident (office, parking lot, shop, cafeteria, etc.).

(7) Procedure being performed when the incident occurred.

(8) Employee’s training.

APPENDIX A: DEFINITIONS

Blood: Human blood, human blood components, and products made from human blood, including plasma, platelets, serosanguinous fluids (for example, exudates from wounds).

Bloodborne Pathogens (BBP): Pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include Hepatitis B virus (HBV) and human immunodeficiency virus (HIV), and any pathogenic microorganism that is present in human blood and can infect and cause disease in persons who are exposed to blood containing the pathogen. Other examples include Hepatitis C, malaria, syphilis, babesiosis, brucellosis, leptospirosis, arboviral infections, relapsing fever, Creutzfeldt-Jakob disease, Human T-lymphotropic Virus Type 1, and viral hemorrhagic fever.

Contaminated: The presence or the reasonably anticipated presence of blood or other potentially infectious materials (OPIM) on a surface or in an item.

Decontamination: The use of physical or chemical means to remove, inactivate, or destroy BBP on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal.

Engineering controls: Controls (e.g. sharps disposal containers, self-sheathing needles) that isolate or remove the BBP hazard from the workplace.

Exposure incident: A specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee’s duties/activities. Non-intact skin includes skin with dermatitis, hangnails, cuts, abrasions, chafing, etc.

Hand washing facilities: A facility that provides an adequate supply of running potable water, soap, and single-use towels or hot air-drying machines.

HBV: Hepatitis B virus.

HIV: Human immunodeficiency virus.

Occupational exposure: Reasonably anticipated potential for exposure; for example, skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee’s duties.

Other potentially infectious materials (OPIM): The following human body fluids:

semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, and all body fluids in situations where it is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids, such as in emergency response. Any unfixed tissue or organ (other than intact skin) from a human (living or dead). HIV-containing cells or tissue cultures, organ cultures, and HIV- or HBV-containing culture media or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

Parenteral: Piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions.

Personal Protective Equipment (PPE): Specialized clothing or equipment worn or used by an employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts, or blouses) not intended to function as protection against a hazard are not considered to be personal protective equipment. PPE is located with automated external defibrillators (AEDs) on the Center, and includes latex gloves and a disposable plastic CPR shield.

Source individual: Any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee.

Examples include, but are not limited to, patients; trauma victims; human remains;

donors of blood, blood components or organs; and subjects of emergency resuscitation.

Sterilize: The use of a physical or chemical procedure to destroy all microbial life, including highly resistant bacterial endospores. Sterilization includes procedures regulated by 9 VAC 20-120-280, “Containment and Cleanup Procedures,” of the Code of Virginia, “Regulated Medical Waste Management.”

Universal precautions: An approach to infection control. According to the concept of Universal precautions, all human blood, and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other BBP. Universal precautions do not apply to feces, nasal secretions, sputum, saliva, sweat, tears, urine, and vomitus, unless they contain visible blood. Adherence to safe work practices and appropriate use of personal protective equipment are essential basic elements of implementation.

Work practice controls: Controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., prohibiting recapping of needles by a two-handed technique).

TABLE OF CONTENTS

PREFACE

P.1 Purpose

P.2 APPLICABILITY

P.3 Authority

a. 29 CFR 1910.1030, “Occupational Exposure to Bloodborne Pathogens.”

b. NPD 1800.2 “NASA Occupational Health Program.”

c. 29 CFR 1904 “Record Keeping”

P.4 APPLICABLE DOCUMENTS AND FORMS

a. NPR 1800.1D, “NASA Occupational Health Program Procedures.”

b. LPR 1845.1, “Automated External Defibrillator Program.”

1. PROGRAM ADMINISTRATION

1.1 Center Director

1.2 Center’s Occupational Health Officer, a function of the Safety Mission Assurance Office

1.3 Supervisors and Managers

1.4 Category I and Category II employees (see descriptions in Chapter 2)

1.5 Occupational Health Clinic

1.6 Contracting Officer’s Representative/Occupational Health Officer/Center Medical Director

2. Exposure Control Plan

APPENDIX A: DEFINITIONS

COVER PAGE

FOR REQUEST FOR QUOTE (RFQ) 80LARC20Q0001

Langley Research Center’s (LaRC) Occupational Health Program Support Requirement

You are invited to submit a quote in response to the NASA Langley Research Center (LaRC) Request for Quote (RFQ) for the Occupational Health Program Support requirement. Potential quoters should pay close attention to the all RFQ instructions; however, the following requirements are summarized to assist in your quote development.

1. This competitive best value source selection will be conducted in accordance with Federal Acquisition

Regulation (FAR) Part 12 Acquisition of Commercial Items, FAR Part 13.5 Simplified Procedures for Certain Commercial Items, and this solicitation using a best value tradeoff between Past Performance and Price.

2. Potential quoters are advised to submit their best offer upon quote submission since the Government anticipates that award will be made without discussions (see FAR 52.212-1, Instructions to Quoters-Commercial Items (Oct 2018).

3. This procurement will be conducted as an 8(a) Small Business set-aside competition under

NAICS code 621999 All Other Miscellaneous Ambulatory Health Care Services, with a size standard of $15.0 annually.

4. RFQ Quote Instructions and Evaluation document contains important information for quote preparation instructions that quoters must strictly follow. The following are highlighted:

• Reference A.7- A pre-quote conference will be held on February 27, 2020. The conference slides and list of attendees will be posted on beta.sam.gov.

• Reference A.12 – Pay close attention to the quote structure (e.g. volumes), formatting, and page limitations. Also note that pages in excess of the limitations will not be considered by the Government.

• Reference A.9 – Quoters are responsible to meet the submission due date as specified in the

RFQ.

• Reference A.13 – For details on electronic email submission of quotes.

5. RFQ Section B sets forth the method of evaluation, evaluation factors for award, and relative importance of the evaluation factors.

6. Potential quoters are advised that changes have been made and incorporated into the final Request for

Quote (RFQ), which included input received from industry regarding the Draft Request for Quote (DRFQ). Please reference RFQ Attachment 10 for the DRFQ Answers to Industry’s Questions document.

COVER PAGE

FOR REQUEST FOR QUOTE (RFQ) 80LARC20Q0001

Verify correct version before use by checking the LMS Web site.

LPR 2710.1 H

Effective Date: September 9, 2016

Expiration Date: September 30, 2021

Subject: Langley Research Center Noise Control and Hearing Conservation Program Responsible Office: Safety and Mission Assurance Office

Contents

PREFACE

P.1 PURPOSE

P.2 APPLICABILITY

P.3 AUTHORITY

P.4 APPLICABLE DOCUMENTS

P.5 MEASUREMENT/VERIFICATION

P.6 CANCELLATION

Chapter 1: INTRODUCTION

1.1 Background

1.2 Definitions and Terminology

1.3 Waivers

Chapter 2: RESPONSIBILITIES

2.1 General

2.2 Hearing Conservation Program Officer

2.3 Occupational Health Clinic

2.4 Supervisors

2.5 Employees

2.6 Procurement Office

Chapter 3: PROCEDURES

3.1 Employees Assigned to the Hearing Conservation Program

3.2 Noise Hazard Evaluation

3.3 Hazardous Noise Areas

3.4 Posting of Hazardous Noise Areas or Equipment

3.5 Engineering Control Measures

3.6 Hearing Protection Devices

3.7 Audiometric Testing and Medical Evaluation

3.8 Training

3.9 Records

3.10 Buy Quiet Requirements for Procurement of New Equipment

Appendix A: DEFINITIONS AND TERMINOLOGY

Appendix B: ACRONYMS

September 9, 2016 LPR 2710.1 H

a. This NASA Langley Research Center Procedural Requirements (LPR) sets forth the procedural requirements and responsibilities for the Langley Research Center (LaRC) Noise Control and Hearing Conservation Program (HCP) under the direction of the Safety and Facility Assurance Branch (SFAB), Safety and Mission Assurance Office (SMAO). It provides specific requirements for protective measures to be taken for employees who may be exposed to hazardous noise levels.

b. The requirements presented in this LPR implement Federal Occupational Safety and Health Administration (OSHA) regulations and NASA management policy for industrial hygiene programs. NASA, contractor management, and operations organizations will supplement the provisions of this procedural requirement by implementation of internal policies and instructions, as needed.

a. These procedural requirements are applicable to all LaRC facilities and personnel.

b. These procedural requirements are to be incorporated in any contract under which contractor employees will be assigned to on-site LaRC hazardous noise or potential hazardous noise areas.

c. Contractors shall provide and implement their own written noise control and HCP.

(1) At a minimum, these programs shall be in accordance with the LaRC program as described herein.

(2) If a contracting company performs work in hazardous noise areas, the HCP shall include regular noise dosimetry to determine worker exposure.

(3) If exposures exceed the action level of 82 dB(A), workers shall be given annual audiograms, training, and be included in an effective HCP.

(4) As with other mandated safety programs, the HCP and associated records of LaRC contractors shall be subject to audit by the Hearing Conservation Program Officer (HCPO) or his/her designated representative.

P.3 AUTHORITY

It is LaRC policy to comply with NASA regulations and Federal Laws as prescribed in the following documents:

a. Noise Control Act of 1972, as amended

b. “Occupational Noise Exposure,” 29 Code of Federal Regulations (CFR) 1910.95

c. “Basic Program Elements for Federal Employee Occupational Safety and Health

Program,” 29 CFR Part 1960

d. Executive Order 12196 of February 26, 1980, “Occupational Safety and Health for Federal Employees”

e. NASA Procedural Requirements (NPR) 1800.2C. “NASA Occupational Health

Program” 2010, Chapter 4.8, “Hearing Conservation”

P.4 APPLICABLE DOCUMENTS

a. NPR 8715.3, NASA General Safety Program Requirements

b. NPR 8715.1, NASA Occupational Safety and Health Programs

c. Langley Policy Directive (LAPD) 1700.2, Safety Assignments and Responsibilities

d. Langley Management System (LMS) Center Procedure (CP) 4760, Reporting Injuries, Illnesses, and Compensation Claims

e. “American National Standards Institute (ANSI)/ Acoustical Society of America (ASA) S3.6-2010” (ANSI/ASA S3.6-2010) 2010, Specification for Audiometers

f. ANSI/ASA S1.4-2014/Part 1 / IEC 61672:1-2013, Specifications for Sound Level Meters

g. American Conference for Governmental Industrial Hygienists, Threshold Limit Values

P.5 MEASUREMENT/VERIFICATION

None

P.6 CANCELLATION

LPR 2710.1, dated December 7, 2015

/s/ Clayton P. Turner September 9, 2016 Center Deputy Director Date

DISTRIBUTION:

CHAPTER 1: INTRODUCTION

1.1 Background

1.1.1 Every effort shall be made to ensure that the work environment affords the necessary protection and conservation of LaRC employees' and contracted employees hearing.

NOTE: Hearing loss due to noise exposure is preventable. Noise-induced hearing loss (NIHL) is a serious threat to people exposed to hazardous noise levels. Loss of hearing can occur from exposure to impulse or impact noise as well as from exposure to steady-state (continuous/intermittent) noise. NIHL may be temporary or may become permanent through repeated unprotected exposure to intense noise. Initial deterioration of hearing may not be apparent to the individual. By the time there is employee awareness of the loss, the impairment may be substantial and irreversible.

1.1.2 The aim of this procedural requirement is to:

a. Minimize noise generated by LaRC operations.

b. Prevent occupational noise-related hearing loss among employees.

c. Provide a work environment free from hazardous noise.

d. Give priority to engineering procedures to the…