Exhibit A - PWS Amendment 3.pdf

NASA LANGLEY RESEARCH CENTER

OCCUPATIONAL HEALTH PROGRAM SUPPORT

PERFORMANCE WORK STATEMENT

The Contractor shall conduct a comprehensive Occupational Health Program for the NASA Langley Research Center (LaRC) located in Hampton, VA. The primary purposes of the Occupational Health Program are: (1.0) Operation of LaRC Occupational Health

Clinic (2.0) Provision of an Employee Assistance Program (EAP); (3.0) Center Occupational Health and Wellness Program

Promotion and Consultation Support .

All items listed in PWS Sections 1.0 Operation of the LaRC Occupational Health Clinic through 6.0 Transition shall be included in the Firm-Fixed-Price Base Services (CLIN 0002). As outlined in PWS Section 8.0, Sections 1.0 through 3.0 shall also be offered on a Fee-for-Service basis.

1.0 Operation of LaRC Occupational Health Clinic:

NASA uses an occupational health program (OHP) to ensure, to the maximum extent practicable, that health care concerns are met consistently and predictably across its many Centers and missions. This includes policies and procedures to ensure strict adherence to

Federal and State law, as well as adopting industry “best practices” and independent industry regulation. NASA’s OHP is broadly described in NPR 1800.1 "NASA Occupational Health Program Procedures” however, the diversity of NASA needs necessitates some flexibility for meeting unpredictable mission needs. The Contractor shall comply with the provisions of the following sections of the

Performance Work Statement (PWS), which exist to implement the requirements in NPR 1800.1, however this PWS is non-exhaustive and exists primarily to identify which sections of NPR 1800.1 are most relevant to Contractor operations. The Contractor is required to follow all Federal and State laws concerning occupational health and safety while performing services for this contract, as well as

NASA policies and the instructions of the Contracting Officer Representative (COR).

The emphasis of the LaRC Occupational Health Clinic is health promotion, illness prevention, prompt treatment or referral of occupational and non-occupational illnesses and injuries. The LaRC Occupational Health Clinic area is a secure portion of the first floor of Building 1216. The LaRC Occupational Health Clinic area consists of several examination rooms, an urgent care room, a laboratory room, a patient records area, an eye exam room/office, an electrocardiogram room, a break room, a hearing testing room, a patient’s waiting room, a meeting/training room, a massage area, and several offices for the staff. The Contractor shall provide all supplies and services required to operate the LaRC Occupational Health Clinic during the normal hours of operation of 7:00 a.m. to

3:30 p.m. Monday through Friday (excluding Federal holidays and other Center-approved closures, or delayed openings). This includes staffing the LaRC Occupational Health Clinic with medical staff capable of providing service to the Centers’ workforce of approximately 1,817 Civil Service employees and 1,700 Contractor personnel (count is from January 2025). The contractor shall also provide all supplies and services outside of normal hours of operation in accordance with PWS Section 1.13, Emergency

Services.

1.1 Changes: These directions are subject to change In Accordance With (IAW) NASA's internal quality assurance policies, which include scheduled reviews of OHP. Questions or concerns that arise from changes in NASA policy which are believed to create an unexpected burden on the Contractor, shall be discussed with the COR. Otherwise, if an inconsistency is created between the instructions in this PWS and a revision to NPR 1800.1 or an interrelated NASA policy, law, or statute, the Contractor shall observe the most recent publication or revision as authoritative unless otherwise specified or unless otherwise instructed by the COR or Office of the Chief Health and Medical Officer (OCHMO).

1.2 Medical Staffing: The Contractor shall provide the services of medical professionals and administrative staff to operate LaRC

Occupational Health Clinic and Occupational Health Programs. This shall include, but is not limited to: On-site Project Manager, Physician(s), Nurse Practitioner/Physician Assistant(s), Registered Nurse(s), and the supporting administrative and/or clerical personnel necessary to operate LaRC Occupational Health Clinic as required by this PWS. The Contractor shall maintain physician and nursing staff to match current center staffing with the ability to flex to meet anticipated Future of Work demands. The Contractor may obtain the services of consultant physicians and other health care professionals/specialists when specialized expertise is needed to supplement the Contractor’s primary staff provided under this PWS.

The Contractor shall provide the following as key personnel: Board Certified Physician who is either a Medical Doctor (M.D.) or a Doctor of Osteopathy (D.O) from an accredited institution or equivalent; be licensed in a U. S. state to practice with specialized training and/or board certification in Aerospace Medicine, Flight Surgeon /Aviation Medical Examiner in accordance with

OCHMO-STD-1880.1 “NASA Aviation Medical Certification Standards”; and a Health and Wellness Program Manager.

1.3 License and Accreditation: The Contractor staff and any other consultant health care professionals/ specialists shall be fully licensed/ accredited by the Commonwealth of Virginia, as well as meet the requirements of NPR 1850.1 “NASA Medical System

Quality Assurance” and Contract Exhibit D “Position Requirements.” In addition, professionals/specialists and key personnel shall maintain professional accreditation, certifications, and credentials appropriate to their fields of medicine while performing the services under this PWS. All Board certifications shall be provided by a board certifying entity in the United States. The Contractor shall ensure laboratory services are provided by a laboratory accredited by an approved accreditation organization, under Occupational

Health Clinical Laboratory Improvement Amendments.

1.4 Physician and/or Nurse Practitioner/Physician Assistant: The Contractor shall ensure that a Nurse Practitioner/Physician Assistant and/or Physician is available on-site at the LaRC Occupational Health Clinic during the normal hours of operation. If the contractor elects to have only a Nurse Practitioner/Physician Assistant on-site, a Physician shall be available (i.e., can be located off-site) for oversight of the Nurse Practitioner/Physician Assistant as required by Virginia Law. The Contractor shall assign a Physician, certified as a Medical Doctor or a Doctor of Osteopathy and experience to serve as the Center Chief Medical Officer and Medical Director (see key personnel in 1.2). The Responsibilities of the Center Medical Director are outlined in NPR 1800.1 and include but are not limited to: 1) Ensure the staff and any other health care providers have and maintain the proper credentials to perform their duties; 2)

Communicate with the COR on any medical, administrative concern, or potential infectious disease within the Center; 3) When requested by the COR or the Center Safety Manager, provide a written medical assessment of a potential job related injuries or illness.

1.5 NASA Occupational Health Community of Practice: Staff shall be made available to participate in all OCHMO - supported functional meetings, forums to receive policy and program updates, and to ensure compliance with standardized NASA Occupational

Health practices described in NPR 1800.1.

1.6 Medical Services to be Performed:

1.6.1 Occupational Medicine: Occupational Medical services shall be under the management of the Center Medical Director. IAW

NPR 1800.1, the Contractor shall comply with the directions of the Center Medical Director and the COR regarding Occupational

Medicine. These directions are subject to change IAW NASA's internal quality assurance policies, which include scheduled reviews of health programs. Questions or concerns that arise from changes in NASA policy which are believed to create an unexpected burden on the Contractor, shall be discussed with the COR.

IAW NPR 1800.1, the Contractor shall observe all requirements of Federal and State regulations, professional standards, and NASA program requirements regarding the LaRC Occupational Health Clinic operations. "Clinic" is a generic term and the requirements of this section apply to all areas where medicine is practiced, or healthcare is provided. The provisions of this section are not limited to

Contractor performance in, or in support of, LaRC Occupational Health Clinic.

The Contractor shall accommodate, if requested by a patient, another clinic personnel to be present in the room during a physical examination.

1.6.2 Prevention, Diagnosis and Treatment of Occupational Illness or Injury: Prevention is considered the foundation of Occupational

Health and is at the core of NASA’s employee health maintaining and enforcing NASA’s policy objectives, especially as they relate to matching Department of Health and Human Services (DHHS) recommendations, guidelines, and goals. IAW NPR 1800.1 and other sections of this PWS, the Contractor shall participate in NASA’s health program. The responsibilities prescribed to OCHMO and

Centers in NPR 1800.1 are the responsibilities of the Contractor.

1.6.3 Injury and Illness: The Contractor shall provide at no-cost to the patient an initial diagnosis and treatment for work-related injury and illness to LaRC Civil Service employee, LaRC Exchange employees, on‐site contractor personnel, visitors, and all other individuals at LaRC. The Contractor shall provide at no-cost to LaRC Civil Service employee, LaRC Exchange employees for follow up appointment if required for, NASA Mishap Investigation System (NMIS) follow up, NMIS investigations, or if need for return to work. The contractor shall provide work-related x-rays services by contracting with a local vendor. The Contractor shall provide medical services IAW LMS-CP-4760 “Reporting Injuries, Illnesses and Compensation Claims” for all work-related injury or illness.

The Contractor shall follow the guidance under PWS Section 9 Fee-for-Service or refer the patient to an outside physician if performing medical services beyond the initial diagnosis and for non-work-related injury or illness. The Contractor shall provide patients an initial dose of medication (prescription or nonprescription) for prompt treatment of symptoms, if required.

The Contractor shall provide written prescriptions to the patient for additional medications, if required by the LaRC Physician or

Nurse Practitioner/Physician’s Assistant. Examples of routinely provided medications include aspirin, ibuprofen, antihistamines, decongestants, topical antibiotic/cortisone/burn ointments, throat lozenges, antibiotics, muscle relaxers, antacids, nitroglycerin, and eye/ear drops.

1.6.4 Occupational-Related Examinations: The Contractor shall provide at no-cost to the patient occupation-related examinations for

LaRC Civil Service employees and LaRC Exchange employees including, but not limited to, pre‐placement; surveillance; job certification; special purpose; job separation or retirement; Flight Physical Examinations IAW NASA Aviation Medical Certification

Standards and other examinations as medically necessary that meet the requirements of NPR 1800.1. X-ray services shall be provided by a local vendor, as needed for LaRC Civil Service employees’ medical protocols to include B-read with the actuals to be billed under CLIN 0002 Other Direct Costs (ODCs). The contractor is required to provide all certifications required to meet NPR 1800.1 as needed to provide all occupational related exams IAW with the Langley LMS-OP-1800.1 “Medical Protocols”. The Contractor shall coordinate with the LaRC Safety Office (LSO) when a patient examination reveals exposure to recognized health hazards, or when information on new health hazards is identified by organizations such as National Institute for Occupational Safety and Health

(NIOSH). The Contractor shall utilize the NIOSH criteria documents as the guideline for medical surveillance of exposed personnel in the absence of a NASA standard.

1.6.5 Pre-Employment: Exams to certify LaRC Civil Service employees and LaRC Exchange employees prior to beginning work, will be performed by the LaRC Occupational Health Clinic, or other means at NASA’s direction. IAW other sections of this PWS and

NASA policy, records generated for these exams shall be maintained in the system of records as directed by NASA and available for

NASA’s access and use. The default means of accomplishing these exams is through the LaRC Occupational Health Clinic, however other methods of satisfying the requirements of NPR 1800.1 may be used if the deviation is approved by NASA.

1.6.6 Preventative Exams: Preventive exams are opt-in at the request of LaRC Contractor, LaRC Civil Service employee, or LaRC

Exchange employee and may be performed at a fee-for-service by LaRC Occupational Health Clinic according to available space and resources in LaRC Occupational Health Clinic.

1.6.7 Mandatory Reporting Requirement: IAW NPR 1800.1 the Contractor shall promptly inform OCHMO and LSO of occupational injuries or illnesses suspected or likely to have an occupational source or cause, which may pose a serious or on-going risk to safety, health, employee readiness, or LaRC operations. The Contractor shall promptly inform OCHMO and LSO of any civil service or contractor employee death on duty, or visitor death on NASA property; cluster investigations; infectious disease outbreaks; Automatic

External Defibrillator (AED) use and outcome; quality of LaRC Occupational Health Clinic care issues; or workplace violence, using as a guide LMS –CP-8621 “Reporting, Investigating and Recordkeeping for Mishaps, Close Calls, and Previously Unidentified

Serious Workplace Hazards” as per NPR 1800.1. Most occupational safety incidents can be resolved at the lowest level practicable however occupational health trends, issues, or concerns should be reported and reflected in OCHMO’s annual health program reviews.

The items identified in NPR 1800.1 are mandatory to report to OCHMO in addition to LPR 8621 “Mishap Preparedness and

Contingency Plan”. OCHMO shall be informed of such mandatory reporting incidents as soon as possible. The contractor shall report into the NMIS https://nmis.sma.nasa.gov/ injuries/illnesses sustained by LaRC Civil Service employees, LaRC Exchange employees, LaRC Contractors, and visitors IAW NPR 8621 “NASA Procedural Requirements for Mishaps and Close Call Reporting, Investigating, and Recordkeeping” that occur on Center, also notify the LSO. Additionally, once notified of external inspections/visits these must also be reported to OCHMO.

1.6.8 Laboratory Services: The Contractor shall arrange laboratory pick-up, drop-off, and testing services. The Contractor shall obtain laboratory samples and complete laboratory draws on-site at the LaRC Occupational Health Clinic, send samples and draws for testing, and follow up with the employee to interpret and discuss results. The contractor shall ensure that the laboratory service provides results in a format that is interoperable with the NASA Electronic Health Records System EHRS.

1.6.9 Optician Services: The Optician services shall be provided at the Optician Office for scheduled appointments. Appointments can be scheduled offsite at the nearest location to NASA Langley Research Center. The Optician Services for LaRC Civil Servant, LaRC

Contractors and LaRC Exchange Personnel Prescription Safety Glasses shall include providing sample frames for selection, processing

Safety Glasses orders using a current prescription from a private provider and performing minor repairs and fitting of new and existing

Safety Glasses.

1.6.10 International Travel: The Contractor shall provide LaRC Civil Service employees and LaRC Exchange employees engaged in international travel for NASA with no-cost to the patient pre‐travel physical assessment, counseling, required immunizations, travel kits consisting of health-related documentation required for the travel destination, and post-travel counseling as required by NPR

1800.1.

1.6.11 Lactation Rooms: IAW Section 4207 of the Patient Protection and Affordable Care Act (ACA) of 2010, the Contractor shall establish and manage, lactation rooms throughout the LaRC (currently there are 8 rooms). The contractor shall ensure the lactation rooms are inspected monthly and have supplies needed for each room, as per the Office of Personnel Management guidelines. The contractor shall coordinate with appropriate personnel to ensure the rooms are capable of being locked and ensure signage is posted to indicate the purpose of the room. The contractor shall report to the COR the monthly utilization rates of each lactation room.

1.7 Medicines and Medical Supplies:

1.7.1 Immunization: IAW NPR 1800.1, maintaining immunity is considered integral to NASA’s disease and infection prevention. The number and type of immunizations required vary based on exposure risk factors such as the type of work performed or performance location, with hazards broadly listed in NPR 1800.1 Appendixes C-1 through C-5. Some professions can elect to decline immunization, according to the hazards present in each profession and each work environment, and the requirements of Office of

Personnel Management (OPM). Voluntarily waiving any vaccination or other health protection measure shall be coordinated with the

COR, who will liaison as necessary with OCHMO, Human Resources, and other departments. However, waiving these protections is considered the exception and not the rule, and for the safety of its employees and the continuity of NASA operations, NASA is not obliged to waive health measures.

The Contractor shall provide all medications and medical supplies necessary to operate the LaRC Occupational Health Clinic and keep two months’ supply in stock for items including, but not limited to: syringes, bandages and adhesives, collection containers, test strips, and isopropyl alcohol. Maintain a stock of occupationally required immunizations including, but not limited to Hepatitis A and B, Tetanus, and Tetanus, Diphtheria, Pertussis (TDAP), considering the availability, and expiration timeframe for each immunization.

The Contractor shall also provide the supplies required to operate the LaRC Occupational Health Clinic Diagnostic Equipment listed in Exhibit C, “Installation Accountable Government Property”.

1.7.2 First Aid Kits: There are no First Aid Kits on Center. However, First Aid Kits may be purchased by Flight Operations and the

Science Directorate for field missions. The LaRC Occupational Health Clinic may be asked to provide recommendations regarding the type of kit needed.

1.8 Other LaRC Occupational Health Clinic Responsibilities:

In addition to occupational health exams and other responsibilities described in this PWS and NPR 1800.1, clinics may have additional missions including but not limited to awareness campaigns, health education, contact tracing, public outreach, etc. These additional duties may change over time in response to evolving health practices, emerging health concerns, new developments in technology, or other circumstances. Contractors may be asked to perform duties not otherwise listed in this PWS, but which are still within the scope of LaRC Occupational Health Clinic’s normal responsibilities and Contractor capacity. The COR will serve as the venue for discussing any concerns that such additional duties may lay beyond the scope of the contract.

The Contractor shall review, assist in the development of, and update various LaRC and NASA policies and procedures relating to occupational medicine, upon written request of the COR. These include, but are not limited to NASA policy documents, LaRC instructions and procedures, and related brochures and pamphlets.

The Contractor shall provide administrative support for medical services using health information management systems that support physical examination management, patient scheduling and notification, reception desk operations, and records management with the capability for statistical and analytical data collection and retention.

The Contractor shall appoint appropriate Medical Staff to serve on standing and special LARC committees including, but not limited to, the Institutional Review Board and the AED Automated External Defibrillator Control Committee, the Quarterly Executive Safety

Council, and the Safety Mission Assurance Office (SMAO) Monthly Business Review. Other than the SMAO Monthly Business

Review, such LaRC committees typically meet on a quarterly basis, with most meetings having a duration of up to two hours.

1.9 Workers Compensation Requirements:

1.9.1 Federal Worker’s Compensation Program: NASA maintains a responsibility to actively participate in a Federal Employees’

Compensation Program (FECA) and meaningfully participate in supporting its employees IAW Department of Labor (DOL) requirements. LaRC Occupational Health Clinic staff serve an essential role in ensuring the employer responsibility to aid and assist

Civil service employees’ work-related injuries, illnesses, or deaths IAW the Limitations on Right to Receive Compensation, 5 USC

8116.

1.9.2 LaRC Occupational Health Clinic Responsibilities for Worker’s Compensation: NASA strictly adheres to the directions and instructions of the DOL who defines the confidentiality rights and requirements of information related to employee compensation and claims. NASA strictly follows DOL policy regarding the routine use and disclosure of information related to the FECA. Contractors supporting LaRC Occupational Health Clinic operations shall understand and adhere to the same DOL policies and local policies.

NASA’s general goal in instances of worker claims is to help LaRC Civil Service employees and LaRC Exchange employees return to work ASAP, even if on light duty. LaRC Occupational Health Clinic otherwise do not make determinations or examinations regarding employee claims. LaRC Civil Service employees and LaRC Exchange employees should be directed to their primary care provider for healthcare questions or concerns; and they should be directed to NASA Shared Services Center (NSSC) for FECA claim questions or concerns.

1.9.3 Processing Injuries and Claims for Workers Compensation: The NSSC is the primary organization for handling FECA claims.

The Contractor shall direct LaRC Civil Service employees and LaRC Exchange employees to the relevant NSSC resources, as necessary, to report and process FECA claims LaRC Civil Service employees and LaRC Exchange employees may see LaRC

Occupational Health Clinic staff for medical examination, but routine care and treatment must be sought through their primary care provider. The Contractor shall support NSSC’s mission by cooperating with requests to gather or submit information pertaining to

NASA employee claims. The Contractor shall report any information pertaining to safety concerns, issues, or injuries to the LSO. The

Contractor shall support the LSO by cooperating with requests to gather or submit information pertaining to NASA safety concerns or reports.

1.9.4 Protecting Employee Rights for Workers Compensation: LaRC Occupational Health Clinic staff shall strictly observe the enumerated employee rights described in NPR 1800.1. LaRC Occupational Health Clinic staff shall not give LaRC Civil Service employees and LaRC Exchange employees the impression, directly or indirectly, that NASA has the authority or ability to adjudicate claims in the FECA program; likewise, LaRC Occupational Health Clinic staff shall never suggest or recommend, directly or indirectly, that a NASA employee should be discouraged from filing a claim for any reason. However, LaRC Occupational Health

Clinic staff who are involved in a claim, such as a witness of an injury event providing an account in support of a claim, shall provide evidence as needed to the DOL Office of Workers’ Compensation Programs and/or NASA to support the DOL’s adjudication of claims and/or as requested by NASA.

1.9.5 Records and Confidentiality for Workers Compensation: All records generated in part or in whole to support FECA claims are covered by DOL/GOVT-1, see Who Maintains Custody and Control of FECA Records, 20 CFR 10.11. This includes all original documents and copies of documents and all records relating to claims for benefits are considered confidential and shall not be released, inspected, copied, or otherwise disclosed except as required in the strict performance of routine duties and observation of

DOL/GOVT-1 and NASA policy, or Freedom of Information Act, 5 USC 552, if such release is consistent with the purpose for which the record was created. LaRC Occupational Health Clinic staff, including the Contractor, shall protect LaRC Civil Service employees and LaRC Exchange employees’ confidential and/or sensitive information from unauthorized disclosure.

1.10 Medical Records:

The Contractor shall:

Maintain accurate and complete medical records for past and currently covered population including retired/terminated employees.

This shall include, but not limited to maintaining accurate and complete data for patient records as per NRRS 1441 NASA Records

Retention Schedule AFS# 1800, Item, 127 Employee Health Records. The repository for these records will be NASA’s EHRS. Work products or records created for NASA efforts, including data entered into the EHRS is the property of NASA and will be maintained for agency needs and purposes, IAW the Privacy Act and other applicable regulations.

The contractor shall only use the Agency-wide EHRS (Cority) for the patient medical records under this contract.

The contractor shall ensure that employee medical records are secure, and confidentiality is maintained.

Records shall be maintained in accordance with the following:

o NPD 1382.17, NASA Privacy Policy o OSHA record-keeping regulations o Health Insurance Portability and Accountability Act (HIPAA) regulations o Health Information Technology for Economic and Clinical Health (HITECH) Act, P.L. 111-5

Ensure medical records are maintained, stored, and disposed of IAW NPR 1441.1, “NASA Record Management Program

Requirements” and the Privacy Act of 1974.

Ensure the information contained in the employee medical record is sufficient to provide data for use in job placement, to establish health maintenance, for treatment and rehabilitation, for use in epidemiological studies, and to assist management with program evaluation and improvement.

Ensure employees have access to their medical records upon receipt of a signed release by the employee or receipt of a notarized designation by the employee or third party.

Ensure medical records are available for NASA medical quality control reviews compliant with HIPAA. To ensure HIPPA compliance, the contractor will need to obtain patient consent to review a patient’s records.

The Contractor shall input required medical certification information and appropriate physical exam data into the Government-provided EHRS and Q-Card for government and on-site contractor personnel who receive occupational related physical exams.

Note: The medical records developed during previous Occupational Health Services contracts will be transferred to the contractor and subject to NASA FAR Supplement (NFS) clause 1852.245-71 Installation-Accountable Government Property. All medical records (electronic) remain the property of NASA.

1.11 LaRC Installation-Accountable LaRC Occupational Health Clinic Equipment and Facility Maintenance: The Contractor shall ensure routine maintenance and upkeep of medically related equipment included in the list of “Installation-Accountable Government

Property”. The Contractor shall ensure that routine maintenance of the LaRC Occupational Health Clinic equipment is performed by qualified technicians, as required by the Original Equipment Manufacturer recommendations. The Contractor shall also complete monthly inspection of the estimated 80 Automated External Defibrillators (AEDs) and Stop the Bleed kits located throughout the

NASA Langley Research Center. The Contractor shall notify the COR if any equipment requires repair or replacement beyond standard maintenance and upkeep. The Contractor shall also continually assess the condition of the LaRC Occupational Health Clinic

Facility and notify the COR of any required or recommended changes that would contribute to the effectiveness of LaRC

Occupational Health Clinic.

1.12 Medical Waste Management:

The contractor shall develop a Medical Waste Management Plan (MWMP) within 60 days of award. The MWMP shall establish standards and procedures that will ensure the medical waste is managed IAW the requirements of Virginia Regulated Medical Waste

Management Regulation Title 9 of the Virginia Administrative Code Chapter 121 (9VAC20-121). The MWMP shall include a list of medical / pharmaceutical waste that is considered hazardous waste (e.g., nitroglycerin). The Contractor is responsible for managing all medical / pharmaceutical waste that is consider hazardous waste IAW LPR 8500.1, Environmental and Energy Program Manuel

Section 7. The Government will only be responsible for disposing of medical/pharmaceutical waste that is consider a hazardous waste.

The MWMP shall be updated annual and submitted to the COR.

The Contractor shall ensure proper handling, storage, and labeling of all medical/bio‐hazard waste for the LaRC Occupational Health

Clinic, IAW OSHA policies and the Virginia Regulated Medical Waste Management Regulation Title 9 of the Virginia Administrative

Code Chapter 121). The Contractor shall appropriately handle the following types of bio‐ hazardous waste generated and/or handled within the LaRC Occupational Health Clinic including but not limited to: cultures and stocks of infectious agents and associated biological waste such as laboratory waste, biological production wastes, vaccines, and related devices; liquid human waste, including blood, blood products, and body fluids; pathological waste including human organs, tissues, body parts other than teeth, and fluids removed by trauma or during emergency treatment or other medical procedures, sharps; including needles, syringes, scalpels, intravenous tubing with needles attached, and any item that is sharp enough to penetrate the skin and is contaminated with potentially infectious material. The Contractor shall be responsible for all costs associated with the disposal of the medical / pharmaceutical waste.

1.13 Emergency Services:

While the primary responder is the Fire Department Emergency Medical Service (EMS), the Contractor shall provide supplemental emergency medical services and EAP services as requested by the COR or EMS (Note: These services would be requested under rare circumstances, such as in response to a tornado or active shooter situation and may fall outside of normal hours of operation). For proposal planning purposes, contractor shall anticipate between 1 to 2 events per year.

2.0 Employee Assistance Program:

The Contractor shall provide and manage the EAP IAW NPR 1800.1. The Contractor shall provide and make EAP services available to all LaRC Civil Service employees and LaRC Exchange employees at no-cost to the patient. The Contractor shall respond to initial

EAP crisis call from LaRC Contractors and Civil Service Retirees and provide them with appropriate referrals or resources. The

Contractor shall provide and make EAP services available to employee spouses and other family members living in the employee’s household, and to all other legal dependents covered by the employee’s health benefit plan for up to five sessions per concern. All persons providing EAP services shall be fully licensed by the Commonwealth of Virginia to provide counseling and rehabilitative services IAW NPR 1800.1. The Contractor shall provide five visits in excess of the maximum number in unusual self-initiated referral cases, when approved by the COR and the Center Occupational Health Officer. The Contractor shall also coordinate with the COR for approval on the number of visits for manager-referral and mandatory-referral cases.

The Contractor supporting LaRC EAP shall coordinate with the COR, IAW, NPR 1800.1 Chapter 5, and Section 1.6 Drug Free

Workplace. All responsibilities identified in this section of the NPR are the responsibilities of the EAP, and specific duties will be assigned to the Contractor according to sections of this PWS.

Basic EAP functions shall include caring for one’s mental wellness on a proactive rather than reactive basis to improve and support productivity and performance in the workplace. The framework through which EAP services are implemented include assessment and short-term counseling, referral to appropriate community or professional resources for long term treatment and rehabilitation, and follow‐up services for effective readjustment after treatment.

The Contractor shall provide EAP Counseling Services 24 hours per day, seven days a week by telephone or virtual appointments.

The Contractor shall make EAP services available to the employee through self- initiated referral, manager-referral, and mandatory referral.

The EAP services shall respond immediately, and not to exceed 5 minutes to the employee. The Contractor shall coordinate with appropriate community resources, such as hospitals and detoxification and care facilities, as required by each individual case.

EAP counseling services provided shall include, but are not limited to, mental health counseling that offers employees the opportunity to speak to a licensed clinical counselor regarding a variety of professional or personal topics which may impact the employee’s well-being and performance in the workplace. Substance use disorder support and referral, and crisis intervention service.

EAP shall also provide resources to include but not limited to, workplace conflict resolution, work life balance, dependent care skills, grief and loss coping skills, personal or social adjustment, medical advocacy, financial and legal consultation.

IAW NPR 1800.1 Chapter 5, where conflict exists between local or state laws and requirements, Federal laws and requirements, and

NASA’s EAP policies, the most stringent requirements will be followed pending specific guidance from NASA. Contractors shall make all reasonable efforts to protect the privacy of LaRC Civil Service employees and LaRC Exchange employees and their families who access EAP resources.

The Contractor shares the responsibility for EAP at LaRC. The Contractor and EAP shall participate in program monitoring tools such as annual reviews and meetings with the Center Director, or no more than twice a year to discuss the state of workforce health, EAP shall attend at a minimum one OCHMO-led event per year. The meetings can be held virtually.

The Contractor shall maintain the program with a goal of restoring the employee to an acceptable work performance level and assisting employees working through personal crises.

The Contractor shall participate on LaRC committees and in meetings at the request of the COR to clarify and promote the objectives of the EAP. Such committees and meetings typically occur once to twice per month for up to two hours per meeting. The Contractor shall report to LSO monthly the number and type of EAP cases.

The Contractor shall provide training and information seminars to LSO or employee groups on subjects related to the NASA EAP

Program at least 5 times yearly by a trained EAP specialist basis and provide presentations at a minimum on a quarterly basis.

EAP providers shall have knowledge and expertise about human behavior and productivity in the workplace (e.g., alcohol and substance abuse, healthy functioning of the workplace, labor relations issues, organizational dynamics, and resolving concerns such as marital, family, financial, legal, emotional stress) and be familiar with EAP requirements and all EAP-related laws and regulations, including Confidentiality of Substance Use Disorder Patient Records, 42 CFR pt. 2, as well as drug treatment/rehabilitative insurance coverage that may be available to employees.

The Contractor shall limit access and use of EAP records to the minimum extent necessary for the performance of duties. The

Contractor shall strictly adhere to the instructions in NPR 1800.1 limiting the discussion or disclosure of EAP records and EAP usage of employees. The Contractor shall strictly adhere to the instructions in NPR 1800.1 and observe the definition list NASA recognizes for EAP records that must be treated as personal mental health files. The Contractor shall strictly adhere to confidentiality safeguards with the storage of electronic EAP records IAW NPR 1800.1 and NPR 2810.1 “Security of Information and Information Systems”.

2.1 Threat Assessment Team: The Contractor may be asked to perform duties as temporary or permanent members of the Center’s

Threat Assessment Team (TAT) IAW NPR 1800.1 and will observe the requirements for participation. The Contractor shall participate in NASA’s “Workplace Violence Awareness and Prevention” IAW NPR 1800.1 Chapter 5 and “NASA’s Domestic

Violence, Sexual Assault and Stalking Response Plan” NPR 3790.1.

2.2 Critical Incident Stress Management: Langley has a formal, written, specific Critical Incident Stress Management (CISM) plan.

The Contractor shall participate in periodic meetings, reviews and revising of these plans based on experience, expertise, and observations during contract performance. IAW LPR 1800.1 and NPR 1800.1, the Contractor shall understand and adhere to the CISM plan for LaRC.

The Contractor shall participate in NASA’s reviews of the EAP program, IAW NPR 1800.1. These reviews may be performed by

LaRC Civil Service employees and LaRC Exchange employees, contractor personnel, or third parties and may be EAP specific or part of other OCHMO and NASA reviews. The Contractor shall participate in the capture of biannual utilization data IAW NPR 1800.1 and provide that data to NASA, and/or assist in the preparation of utilization reports.

3.0 Center Occupational Health and Wellness Program Promotion and Consultation Support:

IAW NPR 1800.1, the program encompasses both health promotion and preventive health elements, health-risk reduction, and the prevention of illnesses and injuries. The multidisciplinary program requires collaboration across health disciplines (e.g., medical, safety, environmental health, physical fitness, employee assistance) to promote holistic approaches. The program seeks to educate and encourage employees to take charge of their own health.

3.1 Program Coordination and Communication: The Contractor shall assess, plan, implement, and evaluate monthly, quarterly, and annual medical and health promotion programs based on the NASA Agency Occupational Health Program, LaRC Center Needs, National Emphasis Programs, and coordination with prominent health-related programs and organizations. The Contractor shall promote and educate the Center workforce on topics such as Physical and Mental Health, Fitness, regular physical exercise, and screenings for early detection of disease, through a variety of venues including, but not limited to Center-Wide Health and Fitness

Campaigns, pamphlets, newsletters, health screenings, lectures, and participation in the LaRC Contractor Steering Council. NASA will provide media resources, including, but not limited to printing services and materials for posters and pamphlets, and NASA will make the LaRC Center website and electronic newsletter available for the Contractor to make routine announcements. The Contractor shall coordinate with the COR and obtain approval prior to the release of any communication issued to the employees at Langley

Research Center. The Contractor shall coordinate with the COR and develop a method and schedule to actively solicit input and customer feedback on the LaRC Occupational Health Clinic and EAP Program.

4.0 Operating Procedures:

The Contractor shall develop and maintain Standard Operating Procedures for the operation of the LaRC Occupational Health Clinic, and Employee Assistance Program. The Contractor shall develop and maintain Emergency Operating Procedures for the LaRC

Occupational Health Clinic, and Employee Assistance Program as approved by the COR. The Contractor may choose to use and/or update the existing standard operating procedures as needed.

5.0 Audits and Inspections Support:

The contractor shall provide administrative and technical support for periodic internal and external program audits and inspections

(typically, three per year) including, but not limited to, those conducted by regulatory agencies such as OSHA, NASA OCHMO, and

NASA HQs Safety and Mission Assurance Office. The contractor shall also assist the COR in the response to, and closure of audit and inspection findings.

The contractor shall support periodic workplace inspections for OSHA and NASA regulatory compliance. The contractor shall provide assistance to applicable NASA/LaRC organizations, investigative organizations, and the regulatory inspector if a complaint is filed or an investigation or inquiry is initiated on a Government or contractor employee.

IAW NPR 1800.1, the Contractor shall cooperate with NASA’s schedules for workplace exposure surveillance and data collection, which involves such things as health questionnaires and workplace safety inspections at any NASA operated location or location within NASA’s area of responsibility.

IAW NPR 1800.1 Chapter 7, NASA conducts occupational health reviews on an annual and triennial schedule, as well as ad hoc investigations when necessary. The Contractor shall follow Occupational Health review requirements and cooperate with such reviews, which may involve interruptions at NASA work sites.

6.0 Transition:

The Contractor shall perform transition activities during the thirty day period prior to the Effective Date of the contract. The

Government will arrange a contract kick-off meeting, the COR will be available for meetings, and the Government will provide the

Contractor with training to include Information Technology Security, NASA EHRS, Chemical Material Tracking System Training, and any other training required to perform on-site at LaRC. In addition, the Contractor will be required to submit documentation of licenses and accreditations to the COR, to verify that the requirements at PWS Section 1.3 are met.

All items listed in the above sections 1.0 Operation of the LaRC Occupational Health Clinic through 6.0 Transition shall be included in the Firm-Fixed-Price Base Services.

7.0 Other Direct Costs (Not-to-Exceed CLIN):

The Contractor shall perform the following services on a cost reimbursable basis with no profit or fee: Rare and Unusual Supplies

Above and Beyond the Medicines and Medical Supplies required in Performance Work Statement Section 1.7; Supplemental

Emergency Medical and EAP Services as requested by the COR outside of normal hours of operation; the material costs for the LaRC

Civil Service employees Safety Glasses orders and other supplies, services, maintenance, and items as authorized by the COR within the general scope of the contract on an as-needed basis.

7.1 Stop the Bleed:

The contractor shall coordinate and offer Stop the Bleed training classes as ODC to LaRC workforce at a minimum of once per month.

The training classes shall be conducted by a Certified Instructor by any Department of Defense approved STOP THE BLEED® instructor course.

7.2 AED/CPR:

The contractor shall coordinate and offer basic AED/CPR training classes as ODC to LaRC workforce at a minimum of once per month. The training classes shall be conducted by an American Heart Association Certified Instructor for AED/CPR.

8.0 Fee-for-Service:

As noted in the PWS Sections 1.0 through 3.0 above, the Contractor shall offer those Medical Services at no cost to the patient for

LaRC Civil Service employees and LaRC Exchange employees as part of the base services of this contract. The Contractor shall also offer those same Medical Services outlined in PWS Sections 1.0 – 3.0, associated materials, and any additional services included in the Contractor’s Fee-for-Service Plan, on a Fee-for-Service basis to LaRC Contractor Employees and LaRC Civil Service Retirees.

The contractor may also offer additional services on a Fee-for-Service basis to LaRC Civil Service employees and LaRC Exchange employees. For any additional services provided, the Contractor shall ensure it provides the necessary level of staffing to provide these services.

The Contractor is responsible for collecting the fees charged by establishing separate billing arrangements with LaRC on-site contractors, for services rendered. The fee-for-services offerings shall be made available with payment being collected by non-insurance methods (e.g., credit/debit card, check).

The Government shall receive a 15% credit on the Fee-for-Service offerings outlined in the Contractor’s Fee-for-Service plan. The contractor shall provide supporting documentation with the monthly invoice and credit to the applicable CLIN as directed by the COR.

Mandatory Fee-For-Services shall include, but not be limited to:

(a) Health Maintenance Examinations: The Contractor shall offer complete and partial Health Maintenance Examinations to all LaRC

Civil Service employees and Contractors. The Health Maintenance Examinations shall be conducted by properly qualified medical staff. The Health Maintenance Examinations shall be conducted IAW NPR 1800.1- Appendix C, Section C6 “Surveillance

Examinations for Employees who Participate in Voluntary Health Maintenance” and in conjunction with US Preventive Services Task

Force recommendation guidelines Type A and B: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations The Contractor shall provide a written report and discussion of the examination results summarizing the state of the employee’s health with each employee examined.

i) IAW the letter dated September 1, 2020, from the LaRC Director to the American Federation of Government Employees

(AFGE) Local No. 1923 (AFL-CIO), hereinafter referred to as the UNION, employees who were members of this union as of, or prior to, June 25, 2020, will not be required to pay any out-of-pocket costs incurred, in association with obtaining a Voluntary Annual

Partial or Complete Health Maintenance Exam. For any remaining costs (as defined above) in association with obtaining a Voluntary

Annual Partial or Complete Health Maintenance Exam, the contractor shall invoice the ODC CLIN IAW FAR 52.212-4(g)(2)

Additional Invoicing Instructions. As of June 2024, there are 56 employees that are a member of the AFGE local 1923 Union who qualify for this coverage.

ii) Note: The difference between a complete and partial Health Maintenance Exam is that the complete exam only occurs every three (3) years during the patient’s birth month, and the partial is offered annually in the interim. The full exam includes a hands-on examination, and the partial exam only includes a consultation, where the provider discusses the results of all testing.

(b) This report shall note any conditions which warrant further attention by the employee’s personal physician. The Contractor shall provide a copy of this report to the patient in person, by mail, or electronic copy per the employee’s written request that discussion is not desired.

(c) All other Mandatory Fee-for-Services outlined in PWS, Appendix A, Mandatory Fee-For-Service Items.

10.0 References and Standards:

The contractor is required to comply with the most recent version of the following:

• NPR 1800.1, NASA Occupational Health Program Procedures

• NPR 1850.1, Quality Assurance of the NASA Medical Care

• NPR 2810.1, Security of Information and Information Systems

• NPR 1441.1, NASA Records Management Program Requirement

• NPR 3790, NASA’s Domestic Violence, Sexual Assault and Stalking Response Plan

• NPR 8621, NASA Procedural Requirements for Mishap and Close Call Reporting, Investigating, and Recordkeeping

• NPR 7900.3, Aircraft Operations Management

• NPD 1382.17, NASA Privacy Policy

• LMS-CP-4760, Reporting Injuries, Illnesses, and Compensation Claims

• LMS-CP-8621, Reporting Investigating, and Recordkeeping for Mishaps, Close Calls and Previously Unidentified Serious

Workplace Hazards

• LPR 1800.1, LaRC Occupational Health Program

• LPR 8621, Langley Research Center Mishap Preparedness and Contingency Plan

• LPR 8500.1, Environmental and Energy Program Manual

Appendix B Contract Breakdown

PWS Section Firm-Fixed-Price Portion of Contract Fee-for-Service Portion of Contract

Operation of LaRC Occupational Health Clinic

• All Services outlined shall be under the firm-fixed price portion of the contract

• N/A

Medical Staffing

• Staffing required to operate the

LaRC Occupational Health Clinic and required Key Personnel.

• N/A

Prevention, Diagnosis and Treatment of

Occupational Illness or Injury

• Initial diagnosis and treatment of

LaRC Civil Service employees, LaRC Exchange employees, on-site Contractor personnel, and other individuals at LaRC

• Beyond initial treatment for injury and illness for LaRC Civil

Service employees, LaRC

Exchange employees, on-site contractor personnel, and other individuals at LaRC

Injury and Illness • Initial diagnosis and treatment for work-related injury and illness to

LaRC Civil Service employees, LaRC Exchange employees, on-site Contractor personnel, on-site individuals including visitors at

LaRC.

• Beyond initial treatment for injury and illness for onsite contractor personnel.

• Follow up appointment if required for, NMIS follow up, NMIS investigations, or if need for return to work.

Occupational-Related Examinations • Occupational-related examinations for LaRC Civil

Service employees and LaRC

Exchange employees.

• Occupational-related examinations for LaRC

Contractors and LaRC Civil

Service…