A02_SOW - Physician and Physical Services (2).pdf

SCOPE OF WORK: PHYSICIAN SERVICES

Scope 1 Line item 1

SCOPE OF WORK FOR PHYSICIAN’S SERVICES

1. SERVICES TO BE PERFORMED. The Contractor shall primarily provide physician's services on- site at the U.S. Army Corps of Engineers Vicksburg District Headquarters (MVK) located at 4155 E. Clay Street, Vicksburg, Mississippi. Although Physician services are regularly provided out of the Vicksburg District facility, performance of physician services may be required at other locations throughout the Vicksburg District.

1.1 Hours of Performance. Services shall be provided Tuesday and Thursday at MVK, Federal holidays excluded, for four hours per day, with the hours of performance to be from 08:00 to 12:00. Days and times of service may be changed by written memorandum of agreement between the parties without modification to the contract. The physician may occasionally be contacted by the Government at other times for medical guidance or assistance during normal business hours. Services will not be required during any period when the location is closed, for example, during inclement weather or on a locally observed holiday.

1.2 Key Personnel. The list of physicians which the Contractor submits with his/her proposal shall be considered the Approved List of Physicians and all physicians on that list shall be considered Key Personnel.

Accordingly, no substitution of personnel shall be made without approval of the Government.

1.3 Continuity of Services. In the event the Contractor's regular physician is unable to provide the scheduled services, the Contractor shall furnish a substitute from the Approved List of Physicians, who shall provide services as specified herein.

1.4 Procedures. Services performed under this contract shall be in accordance with procedures required by AR 40-3, "Medical, Dental and Veterinary Care," and AR 40-5, "Preventive Medicine." A copy of each document will be made available to the physician for use under this contract.

2. SCOPE.

2.1 Occupational Safety and Health. On-site physician's services shall be furnished under this contract for civilian and military employees of the Vicksburg District (MVK) and Mississippi Valley Division (MVD) in support of their occupational safety and health programs.

2.2 Military Sick Call. Physician's services shall be provided in support of limited sick call for the military personnel on active duty at MVK, MVD; and for their eligible dependents 2 years of age and older.

2.3 Emergency Medical Services. For life-threatening medical disorders, such as cardiac arrest, arising during the times the physician is on-site, emergency medical care shall be given to any employee, contractor or visitor at either location, , until the patient can be transferred to emergency medical personnel.

3. CONTRACTOR PERSONNEL MINIMUM QUALIFICATIONS. Physicians performing under this contract shall be licensed medical doctors who are qualified to practice in the Vicksburg, Mississippi area. They shall be graduates of a medical school approved by the Council on Medical Education and Hospitals of the

American Medical Association. Additionally, all physicians performing under this contract shall have education, training, or experience either in preventive medicine or in occupational health.

4. GOVERNMENT RESPONSIBILITIES.

4.1 Support. The Government will provide the following at no cost to the Contractor:

(a) Facilities for patient waiting, interviewing/counseling, examination, treatment, and recovery.

(b) Facilities for the physician's administrative activities.

(c) Storage area for the physician's supplies and equipment.

(d) Furniture and equipment.

(e) Office and patient care supplies.

(f) Patient appointment/scheduling services.

(g) Patient medical record management.

(h) Nursing services (85% of the time).

(i) Utilities, including water, electricity, and telephone services.

(j) On-site transportation necessary for response to medical emergencies and for inspection of the work environment.

(k) Overall management of the health services program, including the establishment of program priorities, non-medical procedures, and policies.

4.2 Employability Decisions. Physicians may be asked to make recommendations to management regarding employability, but physicians do not have authority to release employees from work. The decision as to whether or not an employee is able to perform his/her regular duties (or light duties) is a management, not a medical, decision. Medical information may be relevant, but the Government is responsible for considering other, non-medical issues and for making final decisions on such matters. The responsibility for determining an individual's ability to perform the essential duties of a particular position rests solely with the Government.

5. PHYSICIAN'S RESPONSIBILITIES.

5.1 Medical Direction. The physician shall serve as Agency Medical Official, shall provide medical expertise to the Safety and Occupational Health program, and shall provide to the Nurse such medical guidance as required to perform nursing services.

5.2 Communicate with Patient's Personal Physician and/or with Government-paid Physicians at Remote Locations.

With the patient's consent, the physician may communicate with the patient's personal physician and/or with Government paid physicians at remote locations on all health matters, e.g., abnormal physical findings, emotional disturbance, care of occupational and non-occupational injuries and illnesses, return to work, rehabilitation, and job requirements.

5.3 Immunizations. The physician shall provide medical counsel concerning immunization of civilian employees, military personnel, and eligible military dependents 2 years of age and older.

5.4 Occupational Injuries and Illnesses. In collaboration with the Government nurse, industrial hygienist, and safety specialist, the physician shall provide prompt diagnosis and treatment and shall assist in obtaining rehabilitation services for occupational injuries and illnesses to civilian employees and to military personnel.

5.5 Occupational Physical Examination (Medical Surveillance) Program.

5.5.1 Upon request from the Chief of Occupation Health and Safety, the physician shall work with the registered nurse in establishing appropriate protocols for occupational medical examinations, including such factors as:

employee inclusion criteria, required medical tests and examinations, frequency of tests and examinations, employee notification procedures, interpretation of results, and identification of follow-up requirements.

5.5.2 Occupational physical examinations performed under this contract will usually be one of two types: either pre-hire or periodic. Pre-hire physicals are performed to ensure the potential new employee is physically able to safely perform the duties of the position. Periodic physicals are given to employees who are exposed to environmental conditions which may result in occupational illness or injury.

5.5.3 In addition to performing physical examinations, as the Agency Medical Official, the physician will be required to interpret physical capacities of individuals in relation to the requirements of assigned duties. The physician's interpretation shall be based upon the documented results of a recent medical examination (performed either under this contract or by physicians under separate contract to the Government), all of which will be recorded on Standard Form 78, Record of Physical Examination.

5.5.4 The physician shall discuss and interpret medical findings with individuals when health problems are found. The physician may refer patients for further medical attention as the situation warrants. When appropriate, patients will be encouraged to consult their personal physician. Upon request by the patient's personal physician and with the patient's permission, the results of examinations conducted under this contract will be transmitted to the patient's personal physician.

1.6 Return to Work Evaluations. Upon request by the Government, the physician shall interview or examine an employee returning to work after disability or illness absence and shall review reports from the employee's personal physician. When indicated, the physician shall confer with the employee's personal physician in order to determine the employee's fitness to return to work. The physician shall exercise medical judgment in recommending any appropriate modifications or changes in the employee's normal work assignments, considering the employee's disability, physical requirements of the employee's position, and established Government policy.

1.7 Non-occupational Injuries, Illnesses, and Physical Examinations. See paragraph 2.3, above, regarding life-threatening medical disorders, such as cardiac arrest, arising during the times the physician is available under this contract.

1.7.1 Civilian Employees. The diagnosis and treatment of non-occupational injuries and illnesses among civilian employees are primarily the responsibilities of each individual's personal physician;

therefore, services provided under this contract for these types of injuries/illnesses shall be limited to the following:

(1) First-aid or palliative treatment of minor disorders if the condition is one for which the individual would not reasonably be expected to seek the attention of his/her personal physician.

(2) Treatment which will enable the employee to complete the current work shift before consulting his/her personal physician.

1.7.2 Military Personnel and their Eligible Dependents 2 Years of Age and Older. In the diagnosis and treatment of non-occupational disabilities of military personnel and their eligible dependents 2 years of age and older, physician's services provided under this contract shall be limited to the following as stated in AR 40-5 Preventive Medicine:

(1) Limited sick call: outpatient diagnosis and treatment services not requiring X-rays or lab tests, may include the writing of prescriptions if the physician deems it appropriate. See exclusions listed in paragraph 6, below.

(2) Physicals: preschool and athletic physicals for school-age dependents of military personnel.

5.8 Education, Counseling, and Referral. In collaboration with the nurse, the physician shall counsel and instruct patients in healthful living, in both the work and non-work environment. Patients shall be given advice about health needs and available community facilities.

5.9 Absence/cost Control. At the request of the Government and in collaboration with the nurse, the physician shall:

(1) Examine employees before they leave work due to alleged illness or injury or upon their return to work following absence due to alleged illness or injury.

(2) Examine an employee who has applied for or who is receiving continuation of pay or compensation as a result of an on-the-job injury or disease to determine medical limitations that may affect placement decisions.

(3) Periodically review the personal health records of employees with excessive absenteeism due to illness or injury. On a selective basis, and by request of management, interview or examine employees with frequent or questionable illness absence records.

(4) In support of the Army's goal of reducing Office of Worker's Compensation Program (OWCP) costs: closely monitor (through follow-up evaluations, review of medical reports, or telephonic consultations with the patient's treating physician) the status of any employee who is out of work more than 3 days; advise the treating physician as to the availability of light duty; and assure the treating physician that the Government will adhere to any physical restrictions that he/she may impose.

5.10 Inspection of the Work Environment. As deemed appropriate and necessary, the Government will provide the physician an inspection tour of the work environment for the purpose of detecting and appraising health hazards and to familiarize the physician with the physical requirements of various job categories. The physician shall also provide recommendations for any preventive or corrective actions needed to ensure a safe, healthful work environment.

5.11 Health Record Maintenance. The physician shall assist the nurse in developing and maintaining a complete individual patient health record, including examination reports, care given at each visit to the health service, and illness absentee reports. All health records shall be kept confidential.

5.12 Consultation to Management. Upon request by the Government, the physician shall provide medical consultation to management concerning the Safety and Occupational Health program and related areas such as OWCP, OSHA, and the American with Disabilities Act.

5.13 Evaluation of Requests for Reasonable Accommodations. Upon request by the Government, the physician shall evaluate the medical usefulness of accommodations suggested by the employee or the employee's personal physician.

6. EXCLUSIONS. This contract does not include:

(1) Prenatal, postnatal, and child (less than 2 years old) care.

(2) Obstetrics.

(3) Gynecology.

(4) Surgery.

(5) Routine eye examinations. (Except and identified in para 5 and the section regarding physicals)

(6) Dental care (other than emergency care and palliative treatment).

(7) Laboratory services.

(8) X-ray examinations.

(9) In-patient services.

(10) Drugs and medication.

(11) Ambulance services.

(12) House calls.

(13) Prosthetic devices.

(14) Orthopedic aids.

(15) Inspection of work areas more than 250 miles from Vicksburg, policies.

(16) Nervous, mental, and emotional disorders.

(17) Medical and surgical care of personnel who are hospitalized, or who are receiving treatment under conditions that provides a basis for separate reimbursement.

(18) Drug screening.

7. Hourly rate will be set $155.00 for physician services.

SCOPE OF WORK 2 LINE ITEM 2

Physicals for Employees

Intention Each year, the Corps of Engineers (CoE) hires temporary employees for seasonal work. The contractor will be required to see these new, temporary employees at the contractor's own Health Clinic(s) during regular operating hours. Any physicals or blood work performed by the contractor will be available for pick up the beginning of the next regularly scheduled business day by CoE Safety Office. This will normally be the next Monday.

Scope of Work

USACE requires the services of the contractor to perform physical exams for employees but not to exceed 200 employees for the Mat Sinking Unit. The contractor will be given the Government Documentations use for physicals.

The contractor will be oriented to the documents as attached.

SF 256- Self-Identification of Disability DD Form 2005- Privacy Act Statement-Health Care Records OF Form 178- Certificate of Medical Examination DD Form 2807-1- Report of Medical History Food Handler Questionnaire

All forms must be filled out completely with the exception listed below.

OF Form 178: Part C, 3. Ears. This test will be done separately by the Government.

The physicals will require blood and Urine testing.

The physicals will require EKGs to patents over forty years old or with any cardiovascular history.

The contractor will be required to perform the requested physicals during the base year and each following option year that the government exercises. All physicals will conform to CoE standards as previously stated.

Equipment The contractor shall provide all personnel, equipment and supplies needed to give physicals at their clinic(s) during regularly scheduled office hours.

Physical Requirements

• Give pre-employment physical examinations up to 200 employees per year that will consist of a basic physical that includes at least the following:

Measuring height and weight Eye exam, according to supplied examination form OF 178, section 2 of Part C Other findings, according to supplied examination form OF 178, section 4 of Part C, to include:

Eyes, ears, nose, and throat Abdomen Head and back (including face, hair, and scalp) Peripheral blood vessels Speech Extremities Skin and lymph nodes Heart Back (especially for positions involving strenuous duties) Neurological (including reflexes) and mental health EKG for employees over 40 years old Urinalysis U/A- Dipstick only

Blood work consisting of the following:

CBC (complete blood count) CMP (comprehensive metabolic panel) Lipid Panel

Period of Performance: The services shall be provided as needed.

Place-of-Performance: The services will be performed at the Contractors Medical Office(s). Each Monday morning the prior week’s physicals will be picked up at your medical office by Corps of Engineers medical staff.

Billing Physical with lab/CBC, Lipid Profile, CMP and Urine Dip - $200.00 Over 40-year-old, Physical with lab/CBC, Lipid Profile, CMP, Urine Dip and EKG -$275.00

Inspection and Acceptance:

Work will be inspected and accepted by the government at the MVK Safety Office at 4155 Clay Street, Vicksburg

MS.

Minimum acceptance standard: 98% of physicals must be filled out correctly

SECURITY REQUREMENTS:

1. General security requirements and guidance: The security requirements described below apply to all contract personnel (including employees of the prime Contractor (“Contractor”) and all subcontractor employees) supporting the performance requirements of this contract. The Contractor is responsible for compliance with these security requirements. Questions regarding security matters shall be addressed to the designated Government representative (e.g., Contracting Officer Representative (COR), Requiring Activity (RA) representative, or Contracting Officer (if a COR or other RA representative is not appointed)). Contract personnel are critical to the overall security and safety of US Army Corps of Engineers (USACE) installations, facilities and activities, and security awareness training contributes to those efforts. The Department of Defense (DoD) and Army security training requirements specified below, if applicable, are performance requirements; all applicable contract personnel shall complete initial training within 30 days of contract award or the date new contract personnel begin performance on the contract. Within five business days from the completion of training, the Contractor shall provide written documentation (e.g., email or memorandum) to the Government representative. The documentation shall include the names of contract personnel trained and which training they completed; the Contractor shall maintain training records as part of their contract files and be prepared to provide copies of training certificates to the Government representative. Contractor personnel and vehicles are subject to search when entering federal installations. Additionally, all contract personnel shall comply with Force Protection Condition (FPCON) measures, Random Antiterrorism Measures (commonly referred to as “RAMs”), and Health Protection Condition (HPCON) measures. The Contractor is responsible for meeting performance requirements during elevated FPCON and/or HPCON levels in accordance with applicable RA plans and procedures, to include identifying mission essential and non-mission essential personnel. In addition to the changes otherwise authorized by the changes clause of this contract, should the FPCON or HPCON levels at any individual facility or installation change, the Government may implement security changes that affect contract personnel. The Contractor shall ensure all contract personnel are aware of their security responsibilities, including any site-specific requirements identified in local policies or procedures.

2. Antiterrorism (AT) Level 1 training: All contract personnel requiring routine access to Army installations, facilities, and controlled access areas, or requiring network access shall complete initial and annual refresher AT Level I awareness training. Online AT Level I awareness training is available at https://jko.jten.mil/ (website subject to change).

3. Physical security and access control requirements: All contract personnel requiring physical access to a federal installation or facility shall comply with the access control procedures of that location. Contract personnel requiring unescorted access to meet contract performance requirements on a DoD installation in the US shall be vetted by the installation/facility Provost Marshal/Directorate of Emergency Services/Security Office using the National Crime Information Center-Interstate Identification Index (commonly referred to as “NCIC-III”) and Terrorist Screening Database (commonly referred to as “TSDB”). Contract personnel shall comply with all personal identity verification requirements specified in installation/facility policies and procedures. Contract personnel who do not meet requirements for unescorted access to USACE facilities shall coordinate escorted access with the Government https://jko.jten.mil/ representative, as needed. Contract personnel who receive keys, access cards, or lock combinations that provide access to government-owned property shall comply with key and lock control procedures of the RA.

4. Contract personnel requiring a common access card (CAC): Contract personnel will be issued a common access card (CAC) only if duties involve one of the following: (1) both physical access to a DoD facility and access to DoD information systems or networks; (2) remote access to a DoD information system or network using DoD-approved remote access procedures; or (3) physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. Before CAC issuance, contract personnel must have at a minimum, a favorably adjudicated Tier 1 investigation or an equivalent or higher investigation in accordance with applicable Army regulations and Homeland Security Presidential Directive-12 (HSPD-12). At the discretion of the RA, an initial CAC may be issued based on a favorable review of a fingerprint check and a successfully scheduled Tier 1 investigation with the National Background Investigations Bureau. The RA provides contract personnel with additional information and forms to initiate the CAC issuance process, and/or to initiate background investigations, when required. Contract personnel shall complete these processes within established timelines to avoid delays.

5. Suspicious Activity Reporting training (e.g., iWATCH, CorpsWatch, or See Something, Say Something): All contract personnel shall receive initial and annual refresher training from the RA representative on the local suspicious activity reporting program. This locally developed training provides contract personnel with general information on suspicious behavior, and guidance on reporting suspicious activity to the project manager, security representative or law enforcement entity.

6. Contract personnel requiring access to Government information systems: All contract personnel with access to a government information system (including USACE business systems and CAC-enabled websites) shall comply with applicable DoD and Army regulations and shall use the organization's UserID-Password Administration and Security System (U-PASS) at commencement of services to request network user accounts. Contract personnel shall complete DoD Information Assurance Awareness training prior to accessing information systems, and annually thereafter.

7. Training requirements for the protection of sensitive information: All contract personnel with access to critical information (as identified in the RA's OPSEC Program) shall complete initial and annual refresher OPSEC Level I Awareness training, which is available at the following websites: https://www.iad.gov/ioss/ or http://www.cdse.edu/catalog/operations-security.html (websites subject to change). All contract personnel with access to Controlled Unclassified Information (CUI) shall complete initial and annual refresher CUI training in accordance with applicable Army policy.

8. Escorting in classified and/or sensitive areas: In accordance with applicable regulations, all contract personnel who do not possess the appropriate security clearance or access privileges will be escorted in areas where they may be exposed to classified information or operations, sensitive information or activities, or restricted areas.

9. Pre-screen candidates using E-Verify Program: Contractors shall comply with the requirements set forth in FAR clause 52.222-54 Employment Eligibility Verification and FAR Subpart 22.18 in using the E-Verify Program at (https://www.e-verify.gov/) (website subject to change) to meet the contract employment eligibility requirements.

Contractors are encouraged to cooperate with Federal and State agencies responsible for enforcing labor requirements to include eligibility for employment under United States immigration laws in accordance with FAR 22.102-1(i). An initial list of verified/ eligible candidates shall be provided to the COR no later than three business days after the initial contract award. When contracts are with individuals, the individuals will be required to complete a Form I-9, Employment Eligibility Verification, and submit it to the Contracting Officer to become part of the official contract file.

https://www.iad.gov/ioss/ http://www.cdse.edu/catalog/operations-security.html https://www.e-verify.gov/