80NSSC20736649Q SOW.pdf

STATEMENT OF WORK

for

NASA HEADQUARTERS EMPLOYEES

OCCUPATIONAL HEALTH PROGRAM

General Scope: The Contractor shall furnish the necessary personnel and services to provide, on a five-day per week basis, an Occupational Health Program for NASA Management Office at JPL and NASA Office of Inspector General located at the Jet Propulsion Laboratory and co-located in Long Beach. The NASA contracting office is located at 4800 Oak Grove Drive, Pasadena, CA. The scope of the work includes the maintenance and improvement of the health of employees with emphasis on prevention, diagnosis, treatment, and care of illnesses and injuries caused or aggravated by the work environment. The number of employees involved, as of contract award is approximately 55. However, all participant estimates are subject to change. Such changes will be submitted by official written notice to the Contractor by the Contracting Officer.

Hours of Operation: The Contractor will maintain a local medical facility, five days per week (exclusive of official Government holidays) during regular business hours each day, for a minimum of forty hours per week. A physician and nurse are required to be on site during hours of operation.

Location: The Contractor’s local medical facility must be within a reasonable driving distance from the Jet Propulsion Lab. Employees must be able to schedule and make medical appointments during working hours, while being able to return to work fairly quickly.

Workload: Annual health maintenance examinations will be offered to newly appointed NASA employees and employees transferring from other agencies or NASA installations at the time of their entrance for duty at the NASA Management Office or NASA Office of Inspector General located at JPL in Pasadena, or co-located in Long Beach. The estimated number of employees for which services will be provided will be no more than 55 NASA civil service personnel. Required services will include, but not be limited, to the following:

I. OCCUPATIONAL MEDICINE PROGRAM

A. Health Maintenance/Physical Examinations: The Contractor will provide health maintenance and job fitness examinations for NASA Headquarters civil service personnel in accordance with provisions of NASA Policy Directives (NPD) 1800.2C, “NASA Occupational Medicine Program” or subsequent replacement(s), and NASA Policy Requirements (NPR) 1800.1D, “NASA Occupational Health Program Procedures.” Copies of these documents are available upon request.

1. Scheduling: The contractor will employ a systematic method of employee notification and appointment scheduling which provides for effective management of physical examinations and offers flexibility for rescheduling appointments. The contractor shall attempt to contact all patients the day prior to the scheduled appointment to remind the patient of the appointment.

Where possible, physicals shall be scheduled during the employees’ birth month or as close to their birth months as possible (excluding Government imposed work stoppages). The contractor shall report any scheduling problems or delays to the NMO Medical Contract manager and also via the monthly progress report.

2. Complete Examinations: NASA Civil Service personnel will be offered a complete annual health maintenance physical examination. The examinee has the right to decline any or all of the procedures. The basic examination shall be accomplished in accordance with the provisions as follows:

Voluntary Health Maintenance A. Preventive Health Examination

Reference U.S. Preventive Services Task Force Frequency 1. Offer annually to civil servants

2. Offer at retirement to civil servants if not previously done Laboratory 1. Vital signs

2. Total body skin examination: baseline and when clinically indicated

3. BMI

4. Baseline and when clinically indicated:

a. Visual Acuity

b. Audiogram

c. Pulmonary Function

d. ECG

5. Breast examination

6. PAP smear annually (every 3 years if negative consecutively x 3)

7. PSA test for men age 55 to 70, age 40 with family history or other risk factors

8. Digital Rectal examination offered to men age 40 and older

9. Complete Blood Count (CBC)

10. Blood Chemistry Profile (includes fasting blood glucose)

11. Lipid profile

12. Urinalysis

13. High Sensitivity Fecal Occult Blood

Physical Exam 1. Medical and Family History, if history of smoking—offer smoking cessation

2. Physical Examination Complete baseline then focused as clinically indicated

Counseling/ Education

1. Tobacco cessation, if indicated

2. Healthful diet and physical activity

3. Risk factors based on age, history and examination

4. Breast or testicular self-examination

5. Mammograms every 1-2 years age 40 to 49, every 2 years for age 50 to 74

6. Colonoscopy every 10 years after age 50, earlier with family history (refer to private MD)

Target Organs Multiple Organs Written Opinion A summary of examination and laboratory results provided to the employee along with individualized preventive health recommendations

Likewise, the occupational health program will provide follow-up and monitoring of abnormal findings detected as a result of NASA health maintenance examinations within the scope and schedule that follows:

Hypertension: Offer weekly blood pressure evaluation and referral, as well as consultation with their private physician until adequate therapeutic control has been established.

Hyperlipidemia: Offer quarterly review with referral to and consultation with their private physician until adequate therapeutic control has been established.

Substance Abuse Problems: Provide counseling and/or referral to EAP for employees where possible substance abuse is suspected through medical observation, interview or supervisor recommendation.

Other Conditions: Conduct follow-up and interim medical histories of employees having conditions requiring treatment by their private medical provider.

Consultation/discussion of findings by the physician, along with a written report, will be accomplished. The employee will be given or sent the narrative report.

3. Personnel may be given additional tests, or may be examined at more frequent intervals if clinically indicated, or if other job-related conditions warrant such evaluations. The NASA Contracting Officer must make approval for any such further evaluations in writing.

4. At the time of routine physical examination, the examining physician will evaluate employee regarding medical clearance for participation in a physical fitness program. The NASA Management office will provide Fitness Clearance forms. They will be accomplished with the appropriate clearances and/or restrictions/denials, performed in accordance with the provisions NPR 1800.1D, as follows:

B. Fitness Center Clearance

Reference Frequency Every 3 years (only for individuals referred by Fitness Center) Laboratory Discretionary Physical Exam 1. Review of Physical Activity Readiness Questionnaire (PARQ)

2. Vital signs (blood pressure, pulse)

3. Refer to NASA Occupational Medicine Clinic for clearance if

PARQ responses are positive or vital signs are abnormal

4. Physical examination and appropriate testing required if referred by Occupational Medicine Clinic or employees healthcare provider. Documentation must be received from personal healthcare provider and reviewed by Medical Director. Medical Director responsible for final decision on fitness center clearance

Written Opinion (Clearance)

Medical clearance may specify any limitations in clearance duration (i.e., 1-year) or Fitness Center activity

Once completed, this form will be forwarded to the NASA Management Office.

NOTE: NO private medical information, e.g. diagnoses, will be listed on this Fitness Clearance Form.

5. Other Examinations:

The contractor will provide other examinations of selected NASA employees on an as-need basis.

These examinations may include, but are not limited to, the following:

a. Fitness for Duty (NPR 1800.1C, Appendix C; Section 5A)

b. Return to Work (NPR 1800.1C, Appendix C; Section 5B)

c. International Traveler (NPR 1800.1C, Appendix C; Section 5C)

d. Disability report (NPR 1800.1C, Chapter 6.11.3e)

The NASA Management Office anticipates that these above-listed examinations will happen rarely.

When required, they will be accomplished in accordance with NPR 1800.1D, or subsequent replacements.

6. Administration of Immunizations:

The Contractor shall provide to NASA Civil Service Personnel all immunizations required by local, state, federal, or international laws or regulations, in accordance with NPR 1800.1D, and subsequent replacements. The Contractor will also provide all immunizations required for official overseas travel and will provide appropriately stocked overseas supply kits and other information as necessary. These requirements are on an as-need basis and are expected to be extremely limited. Other immunizations e.g., influenza vaccine, tetanus, etc., compatible with good public health and preventive medicine measures will be offered on a voluntary basis.

7. Other Services to be provided:

a. The Contractor shall review medical documentation and evidence for the NASA worker compensation program, (http://ohp.nasa.gov/disciplines/workers-comp/) Guidance for NASA’s Occupational Health Program may be found at http://ohp.nasa.gov/index.html . The Contractor will be reimbursed for time spent in review and preparation of written statements. This reimbursement will be on an hourly basis at a rate agreed to by the Contractor and NASA.

b. Health Education and Wellness: The Contractor shall make available Health Education/Wellness services to encourage employees to maintain personal health off the job as well as healthful work habits on the job. The program, within capabilities of the staff, may include offering advisory services to employees on physical health and well being, as well as availability of health promotional information upon request. The staff may use NASA’s Health Promotion information, found at http://ohp.nasa.gov/disciplines/hpromo/index.html.

8. Medical Records and Statistics

a. The Contractor shall inform the patient in writing of clinically significant abnormalities, and any findings that warrant follow-up evaluation with the patient’s private physician. Any education provided to the patient, and any recommendations for lifestyle change, will be made in writing to the patient. The Contractor is NOT authorized to pursue follow-up testing or evaluation of any findings discovered on the physical examinations.

The Contractor is responsible for the maintenance of accurate and complete medical records.

The Occupational Medicine Program is responsible for assuring that the employee medical records are secured and confidentially maintained. Records must be maintained in accordance with NPR 1441.1, NASA Records Retention Schedules.

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

Medical records shall be disposed of in accordance with the Health Information Management System (HIMS) in NASA's Privacy Act; Annual Notice and Amendment to Systems of Records.

The medical records (written and electronic) developed during the past contract years will be transferred to a new contractor and shall be subject to the clause entitled “Installation Provided Government Property”.

The medical records shall remain the property of the Government.

The Government will advise the contractor as to how the records shall be maintained and stored.

Access to and copies of employees’ medical records is permitted upon receipt of a signed release by the employee or receipt of a notarized designation by the employee or third party.

b. Privacy of Medical Information:

The Contractor will be responsible for preparing, updating, and maintaining, systemized by date, accurate, complete, and signed hard-copy and electronic medical records. These hard-copy and electronic medical records will remain the property of the Government, though the individual employee will be entitled to a copy of their medical record upon request. Records are confidential information and will be safeguarded in accordance with the Privacy Act of 1974 P.L. 93-579, December 31, 1974 (88 Stat. 1896 et. seq., 5 U.S.C. 552a) and implementing NASA Regulations set forth in 14CFR 1212 et. seq. In particular, the NASA Management Office, the Contracting Officer, the individual’s Supervisor, etc are NOT entitled to the patient’s medical information, and such information will NOT be communicated to them. Violations of the Act may involve the imposition of civil liability, criminal penalties, or both. Such records may be used for purposes of developing and reporting statistical data (e.g. a monthly performance report to the NASA Management Office), and for these purposes will be maintained in such a way as to avoid identifying individuals. The Contractor will also comply with the Health Information Portability and Accountability Act, Title 45 (C.F.R.).

At times when formal communication with the NASA management office is required regarding an individual’s medical qualification to perform job duties, e.g. Return-To-Work

Exam, or Job-Certification Exam, such communication will contain ONLY the determination on the individual’s medical qualification for duty; that is, no diagnoses or other private medical information will be conveyed to the NASA Management Office, the Contracting Officer, the Supervisor, or anyone else who does not have authorization to receive such information, without the individual’s written, signed consent. One mechanism to facilitate such communication is by the Medical Clearance Request form that may be provided by the NASA Management Office. Alternatively, a similar form designed for, and/or used by the Contractor may be utilized.

Access to employees’ medical records will be permitted only upon receipt of a signed release by the employee and or receipt of a notarized designation by the employee or third party.

Copies may be provided to the employee or third party so designated.

9. Clinical and Laboratory Services

The Contractor will obtain laboratory services to be provided by a certified laboratory, which is subject to the approval of the NASA Contracting Officer and the Contracting Officer’s Representative. Specimen preparation and handling will be in the manner specified by the performing laboratory.

10. Medical Supplies and Equipment

The Contractor will be responsible for purchasing of all medical supplies, medicines and services for the maintenance of equipment, and for biohazard waste disposal services, as required to fulfill the scope of this contract and to operate their local medical facility. The Contractor shall maintain appropriately dated materials and supplies sufficient to ensure high quality performance of the contract.

II. OTHER GENERAL REQUIREMENTS

A. In performance of the work hereunder, the Contractor will be responsible for obtaining all necessary permits, licenses, and training, and for complying with all applicable Federal and State laws and regulations, and ensuring that all staff credentials are current.

B. The responsibility and standards of performance (professional, ethical and technical) deemed necessary for the conduct of such a program requires the assignment and utilization of only those personnel whose performance will conform to the acceptable standards and ethics of the medical and allied health care profession.

C. The Contractor will administer the medical program to include maintenance of health records, statistical evaluations, infection control, quality assurance/control, medical quality management, and preparation of professional documentation.

III. PERSONNEL

A. The Contractor must have available qualified personnel at their local medical facility at all times during hours of operation.

B. The physician(s) responsible for these Occupational Health services must be a graduate of an accredited medical school, and must be Board Certified in either Internal Medicine, Preventive Medicine or Emergency Medicine. He/she must be licensed to practice in the State of California.

He/she must have experience as a physician in Occupational Medicine.

C. The Contractor is responsible for ensuring properly trained and qualified staff performs each step of these examinations, including the assessment of vital signs, ECG performance, blood draws, spirometry and audiometric testing. Training and certification requirements will be met, as determined by State requirements and/or local credentialing requirements.