Attachment 1 OHS Performance Work Statement.pdf

PERFORMANCE WORK STATEMENT (PWS)

Attachment 1

PERFORMANCE WORK STATEMENT (PWS)

NASA/Armstrong Flight Research Center

Occupational Health Services

Performance Work Statement

February 28, 2020

1.0 BACKGROUND

1.1 This Performance Works Statement (PWS) describes Occupational Health Services to be performed at the National Aeronautics and Space Administration (NASA) Neil A.

Armstrong Flight Research Center (AFRC), located on Edwards Air Force Base (EAFB) in Edwards, California (CA) and its associated site in Palmdale, CA. The specific services covered are Occupational Medicine to include Occupational Medical Clinic and Health Education and Wellness Program, as well as Environmental Health (EH) to include Industrial Hygiene and Health Physics (Ionizing and Non-Ionizing Radiation) and oversight of the AFRC Food Safety Program. Services specifically EXCLUDED from this PWS are: Employee Assistance Program (EAP), Workplace Drug-Testing (including Specimen Collection and/or Medical Review for drug testing), Workers’ Compensation Case Management, and Environmental Management.

1.2 AFRC, formerly known as the NASA Hugh L. Dryden Flight Research Center, is located approximately 80 miles northeast of Los Angeles, CA. An AFRC component facility (Building 703) supports the AFRC Science Mission Directorate aircraft, and is located in Palmdale, CA, approximately 50 miles northeast of Los Angeles, CA and 32 miles from EAFB. Overall, AFRC conducts aeronautical research and testing, along with airborne science operations, in accordance with NASA’s strategic mission, utilizing about 1,100 on-site personnel— to include Civil Servants, Contractor personnel and other visitors.

1.3 The Contractor’s primary requirement under this contract is to ensure the safety and health of workers through compliance with all applicable laws, regulations, policies standards as well as NASA’s and Center Procedural Requirements. NASA has defined the requirements for an Occupational Health Program under NASA Procedural Requirement (NPR) 1800.1, entitled, “Occupational Health Program Procedures”. Many of these requirements reflect or expand upon other Federal requirements, as promulgated through the Occupational Safety and Health Administration (OSHA), the Federal Aviation Administration (FAA), the Federal Motor Carrier Safety Administration (FMCSA), and various other organizations responsible for establishing industry standards such as the American Conference on Governmental Industrial Hygienists (ACGIH), American National Standard Institute (ANSI) and Institute of Electrical and Electronics Engineers (IEEE) . California OSHA (Cal/OSHA) requirements are also applicable to all contractors working at the Building 703 site (Palmdale, CA). More NASA-specific procedures for implementing these requirements are found in various AFRC Operational Procedures, Standards, Plans and Policies. The PWS outlines what objectives the Contractor shall accomplish to fulfill the specific elements of NPR 1800.1 and related Center documents. For the purposes of this requirement, the term ‘Occupational Medicine’ shall include the Occupational Medical Clinics and the Health Education and Wellness Program, unless otherwise noted. The term “Environmental Health” Program shall include Industrial Hygiene and Health Physics (Ionizing and Non-Ionizing Sources), unless otherwise noted.

2.0 OBJECTIVES

2.1 OCCUPATIONAL MEDICINE

The objectives of the Occupational Medicine function are accomplished through primary (e.g. job certification, fitness center or travel medical examinations), secondary (e.g.

medical surveillance examinations) and tertiary (e.g. illness and injury management, medical emergency response) prevention activities. The Occupational Medicine function also promotes the health of the AFRC workforce through the operation and management of an on-site Fitness Center and wellness campaigns (e.g. flu vaccinations, blood pressure checks). The Contractor’s Occupational Medicine staff shall provide services and materials to meet requirements in the following functional areas:

2.1.1 Job Certification Medical Examinations (e.g. Respirator Use, Crane/Equipment Operation, Aircrew Medical Examinations, etc.)

2.1.2 Federal Aviation Administration (FAA) Medical Examinations (to include First-Class medical certification)

2.1.3 Department of Transportation (DOT) Medical Examinations, i.e. Federal Motor Carrier Safety Administration (FMCSA) Medical Examinations

2.1.4 Travel Clearances and Travel Medical Examinations

2.1.5 Medical Surveillance Examinations (e.g. Audiometry, Lead Exposure Monitoring, Laser Eye Exams, Methylene Chloride medical surveillance, etc.)

2.1.6 Occupational Illness and Injury Examinations

2.1.7 Preventive Health Examinations

2.1.8 Fitness Center Medical Clearances

2.1.9 Health Promotion Activities, such as didactic educational events, blood pressure screenings, staffing a health promotion booth at Safety Day, Vaccination campaigns, etc.

2.1.10 Health-Related Education and Training (e.g. Hearing Conservation, Blood-Borne Pathogens, etc.)

2.1.11 Infection Control

2.1.12 Medical Emergency Response, to include Basic Life Support (BLS) and the initial steps of Advanced Cardiovascular Life Support (ACLS)

2.1.13 Automated External Defibrillator (AED) Program Management. See section 4.1.12 and 4.1.15.

2.1.14 Fitness Center Management (Formal class instruction and/or personal training services are EXCLUDED). See section 4.1.11.

2.1.15 Medical support to the crew and support staff of a commercial space vehicle during simulation exercises and test landings at Edwards AFB, conducted in coordination through NASA AFRC.

2.1.16 Performance of NASA Pilot medical examinations and determination of medical qualification for flight in accordance with NASA and FAA standards.

2.1.17 Performance of FAA First, Second and Third Class Medical Certification examinations.

2.1.18 Identification of medical conditions requiring waiver, and preparation of the aeromedical documentation to support a waiver request (if justified) or for FAA Medical Certification exam cases will follow FAA requirements for FAA Special Issuance.

2.1.19 Preparing aeromedical summaries for presentation to the NASA Aerospace Medicine Board, 2) preparing occupational medicine FMCSA NASA equivalent case summaries (Doctor and NP), 3) presenting cases for FMCSA to NASA HQ Occupational Medicine Board (Doctor and NP), and 4) presenting cases to the NASA Aerospace Medicine Board (Doctor and Doctor for NP). AFRC Chief Medical Officer shall approve documentation format and contents for NASA Aerospace Medicine Board (AMB) presentation narrative summaries.

2.1.20 Review of flight medical questionnaires of qualified non-crewmembers to determine medical qualification for flight.

2.1.21 Review of occupational audiograms to determine work-related hearing loss and OSHA recordability.

2.1.22 Medical direction and quality assurance review of the clinical activity of the Nurse Practitioner.

2.1.23 Serve as a technical expert in answering medical questions posed by NASA Center management.

2.1.24 Provide pharmacy services of a California Board licensed medical doctor who serves as the lab’s director, including any required signatures, as well as the requisitioning or purchase, storage, safeguarding, accountability, and dispensing of all pharmacy supplies, drugs, and medicines necessary for the operation of the medical services facilities at AFRC Main Campus, and B703, Palmdale.

2.2 ENVIRONMENTAL HEALTH (EH)

The objectives of Environmental Health (EH) are accomplished through the anticipation (e.g. document reviews and permits), recognition (e.g. workplace exposure assessment), evaluation (e.g. appropriate sampling, surveillance and analysis of workplace hazards) and control (e.g. recommendation of workplace controls, as well as education, training and certification) of workplace health hazards. Controls generally include: 1) Elimination or substitution; 2) Engineering controls to prevent or minimize exposure to workers; 3) Administrative or work practice controls to prevent or minimize exposure to workers; and/or 4) Appropriate use of personal protective equipment by the worker. The Contractor’s EH staff shall provide support and services based on NPR 1800.1 and other Federal and NASA Requirements such as the following functional areas:

2.2.1 Hazard Communication/ Global Harmonization System (GHS)

2.2.2 Control of Hazardous Substances

2.2.3 Asbestos

2.2.4 Heavy Metals such as: Hexavalent Chromium (Chromium VI), Lead, Cadmium, Beryllium, Mercury, etc.

2.2.5 Benzene

2.2.6 Formaldehyde

2.2.7 Methylene chloride

2.2.8 Blood-Borne Pathogens and Biosafety

2.2.9 Additive Manufacturing

2.2.10 Reproductive and Developmental Health

2.2.11 Hearing Conservation

2.2.12 Ergonomics

2.2.13 Indoor Air Quality

2.2.14 Thermal Stress

2.2.15 Local Exhaust Ventilation

2.2.16 Respiratory Protection

2.2.17 UV Safety Program

2.2.18 Ionizing Safety Radiation

2.2.19 Radiofrequency and Microwave Safety Radiation

2.2.20 Laser and Non-Laser Optical Radiation Safety

2.2.21 Vector Related Disease (e.g. hantavirus, histoplasmosis)

2.2.22 Silica Dust

2.2.23 Food Safety Program

2.2.24 Cryogen Safety

2.2.25 Illumination

2.2.26 Water Quality

2.2.27 Hydrazine safety

3.0 SCOPE

3.1 OCCUPATIONAL MEDICINE (OM)

3.1.1 Size - The medical facility at AFRC is referred to as the “Health Unit” (bldg. 4822). The AFRC Health Unit is located on the main campus, with a separate Medical Office operated at Building 703. Additionally, the AFRC Fitness Center (bldg. 4876) is a 4,350 square foot facility, which has two large fitness areas (one primarily for equipment, the other for stretching, aerobics and group exercise); the facility includes men’s and women’s locker rooms and shower facilities, as well as an administrative office. On average, 25-30 employees (Civil Servant and Contractor) utilize the facility each work day.

3.1.2 Job Certification Physical Examinations: Job certification physicals address the question of whether an employee is medically qualified to perform a specific job or function. These examinations assure the employing organization (as well as the individual and the individual’s Supervisor) that the individual is medically qualified to perform the job, or a specific aspect of the job (e.g. respirator use). Job certification examinations are provided by NASA at no cost to the employee (Civil Servant or Contractors). Many of these exams are accomplished in accordance with guidance from OSHA, NASA, or other regulatory authorities. Communication of the assessment is made to the responsible parties (usually the Supervisor and employee) in written format (e.g. the AFRC “Request for Medical Clearance” form).

3.1.3 Medical Surveillance Examinations: Medical surveillance exams address the question of whether the work or its environment is producing deleterious health effects on the employee. As such, medical surveillance examinations are a type of monitoring tool for health and safety in the workplace. At AFRC, various environmental health programs include requirements for medical surveillance; such as Hearing Conservation Program, Respiratory Protection Program, Bloodborne Pathogen Program, Confined Space Program, OSHA specific chemical hazards (e.g. Lead and methylene chloride), Laser Safety Program and Radiation Safety Program. A communication of certification examinations are made to the responsible parties in written format.

3.1.4 Periodic Health Maintenance Examinations: Preventive Health Examinations (also referred to as “Executive Physicals”) consist of screening observations or tests to detect disease in an early, more treatable phase, before symptoms manifest and are more detrimental. Periodic health maintenance examinations are offered to Civil Servants as a benefit of their employment; however, these exams are voluntary. The scope and frequency of the exam is specified in NPR 1800.1.

3.1.5 Fitness Center Management: Contractor will manage the operation of the Fitness Center and provide medical clearance for use of the Fitness Center.

3.1.6 Travel Clearances: NASA Civil Servants who are traveling overseas shall receive a medical evaluation and clearance performed in accordance with NPR 1800.1. When requested or when the Health Unit recognizes the need, the Occupational Health Contractor shall perform travel medical evaluations and provide recommended travel preventive medicine services, meeting the United States Centers for Disease Control recommendations, to other NASA resident contractors traveling outside the United States.

3.1.7 Qualifying Non-Crew Member (QNC) clearance: for AFRC personnel (Civil Servants and Contractors) who perform QNC duties, contractor will perform in-person examinations and ensure appropriate occupational health needs of these QNC workers.

Non-AFRC workers who request QNC clearance will be cleared by review of QNC medical questionnaires and further clarifying medical information will be requested from the worker when needed based on the responses to the questionnaire.

3.1.8 Occupational Illnesses & Injuries: The Occupational Medical staff shall treat and manage the occasional work-related injury or illness. All AFRC personnel (Civil Servants and Contractors) with occupational illnesses or injuries may be initially treated within the capabilities of the AFRC Health Unit. There is no on-site X-ray or laboratory capability, so more complicated or serious injuries and illnesses are referred to the patient’s private medical provider off-site. Both Civil Servants and Contractor employees have a choice as to who their treating doctor (Medical Doctor- Doctor of Medicine or DO-Doctor of Osteopathic Medicine) will be for an occupational illness or injury, i.e. the employee is encouraged, but not required, to go to the AFRC Health Unit for their illness or injury.

Contractors may have their own “preferred providers” for injured or ill employees, separate from the AFRC Health Unit. More detailed procedures for addressing workplace (occupational) injuries, illnesses, and communicating such information to the employer (i.e. the Supervisor) are provided in specific NASA and AFRC guidance.

3.1.9 Non-Occupational Injuries & Illnesses: The NASA Occupational Health Program dictates that Health Unit staff WILL NOT act as the employee’s personal medical doctor (PMD) or primary care provider. The AFRC Health Unit generally does not address, treat, or dispense medications for non-occupational illnesses and injuries. When in the best interests of NASA, the Health Unit may address and treat—on a one-time basis— non-occupational illnesses and injuries of AFRC Civil Servants, (e.g.

respiratory infections, gastroenteritis or non-work-related injuries). All follow-up or ongoing care shall be provided by the employee’s PMD.

Contractor employees must see their PMD for all non-occupational medical needs, unless it is an urgent or emergent condition (e.g. heart attack, stroke, etc.).

3.1.10 Medical Emergency Response: Although the AFRC Health Unit does not operate a formal ambulance service, Health Unit staff shall respond to medical emergencies during regular duty hours that occur at AFRC main campus and at times contractor’s Occupational Health staff is present at Building 703. On main campus, the staff shall use the Medical Emergency Response Vehicle (MERV); at Building 703 staff shall respond by foot, as there is no MERV located at the Palmdale facility. The scene may be an industrial area such as an aircraft hangar, or elsewhere within a building.

The Health Unit staff shall NOT proceed into an area or structure unless it is safe. The determination of an area’s safety, when not obvious, will be made by the On-Scene Commander (e.g. Fire Chief, Safety, Health and Environmental Officer, Protective Services, etc.). Contractor personnel shall NOT drive the AFRC MERV off the confines of Edwards Air Force Base.

3.1.11 NASA Mishap Information System (NMIS): NASA has various safety reporting systems. The contractor’s Occupational Health staff shall ensure all occupational medical related incidents be entered into NMIS following NASA’s NPR 8621.1C- NASA Procedural Requirement for Mishap and

Close Call Reporting, Investigating, and Record Keeping.

3.1.12 Administrative and Medical Record/Document support: The AFRC Health unit (HU) medical services and Clinic Director require the support of a technical/clinical documents/medical records information specialist.

This specialist will do at minimum the following:

3.2.6.3 Coordinate with AFRC civil servant and contract employees to set-up appointments for visits to the HU in support of required occupational health certifications/approvals.

3.2.6.4 Updating clients’ medical records in the NASA

Occupational Health electronic health record system.

3.2.6.5 Updating clients’ training records for required occupational health trainings.

3.2.6.6 Coordinating appointments for AFRC civil servants’

executive medical examinations.

3.2.6.7 Assisting Nurse Practitioner/Physician Assistant/or Doctor (MD or DO) with the coordination of Wellness Campaigns and management of the Fitness Center.

3.2.6.8 Compiling metrics data from several Occupation health programs, including participation in activities or use of the AFRC Fitness Center.

3.2.6.9 Assisting and managing with the coordination and Center logistics of all Occupational Health audit visits, including the tri-annual OCHMO audit (rooms, phones, computers, and setting up of Center Management meetings/ presentations in support of the audit visit).

3.2 ENVIRONMENTAL HEALTH (EH)

3.2.1 Size: The AFRC main campus occupies approximately 880 acres, and consists of buildings with approximately 900,000 square feet of structural floor space. Building 703, in Palmdale, occupies approximately 16 acres and consists of one building with approximately 428,000 square feet of structural floor space. Overall, AFRC structures include cafeteria, gift shop, aircraft hangars, industrial shops, fuel stations, a motor pool, research engineering workshops, flight simulation facilities, fabrication shop, research aircraft platforms, fiber optics labs, material testing lab, ejection seat maintenance shop, communication and telemetry facilities, a mirror coating facility, an airborne science integration facility, an occupation health clinic, and office space. AFRC has a workforce composed of approximately 533 Civil Servants and 786 on-site contractors, as well as a few visiting researchers and investigators.

3.2.2 Hazardous Operation review/evaluation and permitting: Various work processes and hazardous operations may have a need for Environmental Health reviews and evaluations, and in some cases, formal permitting.

Various workgroups throughout the Center will often utilize regulated chemicals or have other hazardous operations. These may require the issuance of an Evaluation and Recommendation/Requirements Report, as well as formal permits/authorizations (e.g. Class IIIb or 4 lasers, Ionizing Radiation and Radio Frequency Devices, nuclear gauge permits). In addition, Changes to the infrastructure, facilities or work processes can potentially expose workers to health hazards not previously identified or mitigated (e.g. new chemicals, unforeseen ergonomic challenges, increases in power of radiation devices, etc.) and these will require Environmental Health evaluations. There are also isolated incidents (e.g.

foul smell in the work area, unusual taste to the drinking water, etc.) that occasionally require prompt IH evaluations and recommendations.

3.2.3 Exposure Assessments: Exposure assessments are a proactive method by which the IH staff evaluate a functional work area with regards to the hazards and programs identified in Section 2.2. In this on-going process the presence, or absence, of the specific hazard for a given work area is documented, and if present, its potential hazard to workers is assessed in a quantifiable manner. Workers potentially exposed to the hazard(s) are identified, and mitigation steps are developed. These steps may include required training, medical examination, engineering or administrative controls, and/or the use of personal protective equipment (PPE).

3.2.4 Sampling and Surveillance: AFRC utilizes two common sampling techniques: a) surveys and monitoring of exposure conducted with direct reading instruments or passive samplers and b) sampling of specific substances, with subsequent shipping to an appropriate laboratory for processing and analysis. The various equipment and instruments used for surveying and sampling must be maintained on a regular basis, bump-tested on a regular schedule and calibrated to established standards.

Environmental Health contract staff shall maintain such equipment and instruments according to established standard operating procedures, and ensure items are bump tested and calibrated on the prescribe schedule per standards and NASA requirements. Contractor shall also maintain associated logs, records, and databases. NASA will provide the actual equipment or instruments. NASA will also perform and/or coordinate the calibration. Contract staff will coordinate the with NASA AFRC’s Calibration group. NASA will provide any additional costs of maintenance beyond normal inspection and care of the equipment or instrument.

3.2.5 Dosimetry and Direct Readers for Radiation Exposure: The AFRC Radiation Safety Program provides Thermoluminescent (TLDs) dosimeter to all radiation workers. The Environmental Health contractor shall coordinate and implement the TLD program, which consists of processing new program participant requests, “Safe Use of TLD” training, quarterly TLD exchanging, retrieving TLDs from employees leaving the TLD program, and providing each employee with their individual annual exposure reports.

3.2.6 Reports: A variety of reports or other methods of documentation are produced by the Environmental Health group. These include: survey reports, evaluations, exposure assessments, annual program self-assessments, data analysis, trending analysis, deficiencies within regulatory requirements, document reviews, mishap reports, progress and metric reporting, improvement and recommendation/requirements reporting, and detail requirements for mitigation and control of the potential hazard(s). In addition, the Radiation Safety Program has an annual requirement for a report based on a comprehensive review of the ionizing and non-ionizing radiation program.

3.2.6.1 The contract Environmental Health personnel shall provide the appropriate draft reports (information, requirements and recommendations) to the responsible NASA AFRC Program Manager for IH or HP for their review and concurrence thus facilitating informed decisions that minimize health risk of center personnel. NASA will provide the contractor with any required templates and/or format for these reports.

3.2.7 Implementation and Coordination of Hazard Controls:

There may be the need for the coordination and implementation of hazard controls based on surveys, assessments, and evaluations. The Environmental Health Contractor shall provide the IH and HP PM with viable options for the coordination and/or implementation of EH controls. For example, training, signage, permits and engineering controls. The contractor shall support the implementation of these controls.

3.2.8 Education and Training: The AFRC workplace safety and health program requires specific training to be accomplished by the worker. Some training can be accomplished online through the NASA-provided online learning system. However, some training must be accomplished in-person (e.g.

respirator use and fit-testing).

3.2.8.1 The Environmental Health staff shall provide required training, as defined within their areas of responsibility, in accordance with nationally recognized standards. In addition, the contractor staff shall coordinate two annual awareness training campaigns for Center employees. Campaign subject will be coordinated with the AFRC EH Program Managers. One of these may be in conjunction with the AFRC Safety Day Activities.

3.2.8.2 The Environmental Health Staff will track and document training.

3.2.9 Recordkeeping:

The AFRC EH Program requires accurate and updated record keeping information. NASA has a prescribe Record Management Program for these functional areas. The contractor is to ensure that all EH records are kept in accordance to NASA Record Management requirements NPR 1440.6I.

3.2.10 Database Development and Management System

The EH program is intensively regulated with very prescribe requirements that may have prescribed schedules. The Environmental Health Contract Staff is to develop a management scheduling database for the EH Program that may include, among its functional components: EH equipment maintenance, bump-test and calibration schedules, regular exposure surveys and assessments (e.g. x-ray cabinet annual surveys, x-ray producing devices, x-ray vault annual survey, noise surveys, and chemical surveys), area radiation surveys, leak tests, annual radiation areas and devices inspections, exposure assessment schedule, dosimetry schedule, AFRC permit schedules, updating of AFRC’s radiation devices inventories (RF, Laser and Ionizing Radiation), training schedule, annual awareness trainings (RF, lasers, asbestos, lead) and EH facility inspections.

3.2.11 Development of an Occupational Medicine and Environmental Health Newsletter

3.2.11.1 Newsletter will be electronic and sent to customers on a quarterly basis (Winter, Spring, Summer and Fall)

3.2.11.2 Newsletter is to include:

3.2.11.2.1 General short article on the season related to EH

and/or Occupational Medicine.

3.2.11.2.2 An example may be an AFRC research project that

may be partnering with the EH group for intensive support.

3.2.11.2.3 Another example may be an article on flu season.

3.2.11.2.4 Any upcoming event of interest to customer related to

EH and/or occupational medicine.

3.2.11.2.5 Upcoming permit due-dates.

3.2.11.3 Environmental Health Contractor may use format and

information from the OCHMO newsletter and the Goddard Radiation Safety Newsletter, as well as any other vetted document.

3.2.11.4 Inclusion of any trends based on hazard exposure data.

3.2.11.4.1 For example, highest ergonomic risk factors observed at AFRC during the year (e.g. bad posture).

3.2.11.4.2 Most prevalent hazard at AFRC (e.g. noise).

3.2.11.5 Newsletter will be approved by the COR prior to distribution.

4.0 Requirements

4.1 Occupational Medicine (OM), the Contractor shall:

4.1.1 Operate the AFRC Health Unit at Edwards campus and bldg. 703 in accordance with the operational hours and work schedule for AFRC, provided under the Section entitled, “Standard Work Hours”.

4.1.2 The AFRC Edwards Campus will operate with a minimum of one Licensed Medical Professional (LMP) between the hours of 07:00 - 07:30 AM, and 4:00 – 4:30 PM (3:00 – 3:30 PM on working Fridays) on work days.

4.1.3 The AFRC Edwards Campus will operate with a minimum of TWO of the following Licensed Medical Professionals (LMP) will be required on working weekdays Monday - Friday (7:30-4:00pm):

a) (e.g. A Nurse Practitioner/ Physician Assistant and a Registered Nurse (with a doctor available for consultation when needed) or

b) A doctor (MD or DO) and a Registered Nurse

4.1.4 A doctor (MD or DO) shall be the Medical Director of the Health Unit and shall perform, as needed, aviation medical examinations including NASA First, Second, and Third Class Aviation Medical Exams, FAA First, Second, and Third Class medical certification exams (i.e. must be a FAA Senior Aviation Medical Examiner), and NASA Qualified Non-crewmember certification, in addition to other duties consistent with required qualifications for the doctor (MD or DO) position.

4.1.3.1 The Contractor is expected to operate at AFRC’s bldg. 703 Medical Office one 8-hour day per week. There may be times when the contract doctor (MD or DO) might need to schedule two days in a week in support of science missions. This will not be the norm. When the civil servant doctor (MD or DO) is operating out of bldg. 703, only one contractor staff member will be required to be scheduled the same day and time at the bldg. 703 - Medical Office.

4.1.3.2 When the civil servant doctor (MD or DO) is NOT operating out of bldg.703 that week, the Contractor shall provide at least two (2) personnel one (1) doctor (MD or DO), Clinician, or Registered Nurse, and another staff member who may be a LMP or a clerical contractor staff member scheduled on the same day and during the same hours, in accordance with the operational hours and work schedule for AFRC, bldg.703, provided under the Section entitled, “Standard Work Hours”.

This staff member does not need to be an LMP.

4.1.3.3 The AFRC Chief Medical Officer may request a change on the distribution for hours of coverage on weeks, based on the AFRC Health Unit priorities. This request will not change the total hours of contractor support, just the location of the support for a week.

4.1.3.4 Contractor staff support shall register arrival and discharge of employees presenting for evaluation into the Electronic Health Record and serve as a chaperone to the LMP or civil servant doctor (MD or DO) while employees are present for exams.

4.1.3.5 Required Contractor support hours to the medical office at bldg. 703 does not include other contractor responsibilities such as first aid and AED training.

4.1.4 Prepare a variety of medical presentations such as: aeromedical summaries for presentation to the NASA Aerospace Medicine Board,

2) occupational medicine FMCSA NASA equivalent case summaries (Doctor and NP), 3) presenting cases for FMCSA to NASA HQ Occupational Medicine Board (Doctor and NP), and 4) presenting cases to the NASA Aerospace Medicine Board (Doctor and Doctor for NP).

4.1.5 Coordinate the disposal of regulated medical waste and expired pharmaceuticals with a disposal contractor. The government will pay all costs associated with disposal.

4.1.6 Perform work-related medical examinations in accordance with NPR

1800.1 and other applicable regulatory agencies. The Contractor shall provide staff who possess the knowledge, skills and abilities to perform medical examinations, to include:

4.1.6.1 Vital Signs (i.e. height and weight measurement, blood pressure measurement using an automated sphygmomanometer, oral temperature using an automated oral probe, respiratory rate and heart rate);

4.1.6.2 Pure-Tone Audiometry;

4.1.6.3 12-lead Electrocardiography (EKG);

4.1.6.4 Phlebotomy;

4.1.6.5 Intravenous (IV) Line Insertion and Maintenance;

4.1.6.6 Spirometry (Pulmonary Function Testing);

4.1.6.7 Vision Testing (Using a standard Optec® or Titmus®

Vision Testing Machine provided by NASA);

4.1.6.8 Urine Dipstick Analysis;

4.1.6.9 Finger stick glucose sample collection and analysis as well as:

4.1.6.10 FMCSA Medical Certification;

4.1.6.11 FAA Aviation Medical Certification, to include First-Class, Second-Class and Third-Class Medical Certifications (FAA Senior Aviation Medical Examiner is required to perform First-Class exams and certifications).

4.1.6.12 NASA First, Second, and Third-Class Aviation Medical Exam Certifications (FAA Senior Aviation Medical Examiner is required to perform NASA First Class exams and certifications)

4.1.6.13 Qualified Non-crewmember Certifications [A doctor (MD or DO) is required to perform these certifications].

4.1.7 Review appropriate tests and laboratory results required by such exams (e.g. hearing tests, pulmonary function tests, laboratory tests, etc.), and direct appropriate follow-up as indicated.

4.1.8 Assess, treat and manage workplace illnesses and injuries within the purview of the Health Unit (i.e. there is no "STAT" lab capability except for dip urinalysis and finger stick glucose, no radiology capability, and no inpatient capability on-site).

4.1.9 Assess and treat (within the Clinician’s scope of practice and within the purview of the Health Unit) urgent or emergent conditions, such as acute coronary syndrome, acute myocardial infarction, or cerebrovascular accident (stroke) on an initial (i.e. urgent or emergence) basis. The staff shall immediately arrange urgent/emergent transport of the patient to higher levels of care via ambulance when the need is identified.

4.1.10 Respond immediately to 911 emergency calls in accordance with the Center’s Emergency Preparedness and Response Plan. The response shall specifically include:

4.1.10.1 The cessation of all current activities (assuming they are not themselves life-saving activities);

4.1.10.2 Acquiring the necessary emergency information for

response;

4.1.10.3 Loading the MERV (when at Edward’s campus) with pre-determined bags and equipment (NASA will determine the medications and equipment in these bags);

4.1.10.4 Driving the MERV (and other staff when emergency is at Edward’s campus) in an emergency manner (i.e. emergency lights and siren, if indicated—with due regard for safety) to the scene of the emergency;

4.1.10.5 Stabilizing the patient(s) to the extent possible in accordance with standard BLS and/or ACLS protocols;

4.1.10.6 Ensuring patients needing further care are transported to an off- site hospital using the paramedic ambulance service, i.e. the Edwards Air Force Base Paramedic Ambulance Service (AFRC Main Campus), or the Los Angeles County Fire Department (Bldg. 703 Palmdale), as outlined in AFRC guidance.

4.1.11 Respond to all Center Mass Casualty Emergencies following AFPL8710.1-001-Emergency Management.

4.1.12 Assess non-work-related illnesses. The Clinician shall not prescribe or furnish medications unavailable in the Health Unit.

4.1.12.1 Medications will only be furnished from the AFRC Health Unit in accordance with Health Unit policies and protocols.

Medications shall be furnished in dosages routinely prescribed, when indicated and appropriate for the patient.

No prescriptions shall be written by the Contractor Clinician. Drug, strength and directions for use shall be documented in the electronic health record system, and patients shall be provided with the appropriate educational information regarding furnished drugs or devices. The medications available in the Health Unit will be determined by NASA. The Contractor shall be provided access to NASA Occupational Health Databases used in the performance of these requirements (e.g. Electronic Health Record System).

4.1.13 Manage AFRC’s Fitness Center by performing the following:

4.1.13.1 Conduct a walk-through each morning of the Fitness Center during the regular work-week.

4.1.13.2 Health Unit staff shall provide sporadic monitoring for safety purposes of the Fitness Center via closed-circuit television monitors provided by the Government located in the Health Unit.

4.1.13.3 Evaluate employees’ medical clearances required to use the Fitness Center facility. Clearances are valid for one year.

4.1.13.4 Grant card reader access to the Fitness Center, only to participants that hold a current medical clearance.

4.1.13.5 Coordinate with AFRC Code 220 (Facility) for any

custodial or maintenance issue regarding the Fitness Center building. Coordinate new or existing equipment placement and/or rearrangement within the facility, routine AFRC safety inspections, routine equipment inspections as well as the purchase and removal of any malfunctioning, recalled or broken equipment. NASA will approve and procure of the required services. The Contractor shall be responsible for notifying the Government if/when equipment is not functional. The Government will then direct its repair or removal, at the expense of the Government. For issues identified in the regular safety inspection or any other audit, the contractor will ensure deficiencies are resolved.

The contractor will provide a list to the government of needed locker supplies to ensure locker/bathroom area is safe and functional. Contractor will ensure these are properly installed. This will include coordinating with AFRC housekeeping. It is the Government responsibility to cover all expenses required to maintain locker supplies.

AFRC Housekeeping will perform the required routine cleaning.

4.1.13.6 The contractor will ensure appropriate safety/health signage is posted at the Fitness Center.

4.1.13.7 The Contractor shall be responsible for notifying the Government if/when equipment is not functional.

4.1.13.8 The Fitness Center is open 24 hours for employee use.

However, the contractor is NOT required to supervise hourly activities at the fitness center.

4.1.13.9 Ensure all new Fitness Center participants get a tour of the facility and understand the general safety rules for the use of the facility; as well as provide usage and training brochures.

4.1.13.10 Obtaining data from AFRC Security on the Fitness Center usage and analyze trends.

4.1.14 The Contractor will provide an Automated External Defibrillator (AED) Coordinator to manage the AFRC AED Program in accordance with NPR 8100.1. Specifically, the AED Coordinator shall:

4.1.14.1 Document the location of each AED on site;

4.1.14.2 Develop an inventory of all devices and their warranty expiration dates, dates of regular inspections, maintenance and any other required information;

4.1.14.3 Ensure each AED is checked on a periodic basis (no less frequently than quarterly) to determine if the signal light is blinking normally;

4.1.14.4 Document the lot number and expiration date of the batteries, the pads and the replacement pads (when applicable) to each defibrillator;

4.1.14.5 Coordinate with the designated point-of-contact for each defibrillator and alert that individual within three months of an expiration date of either the batteries or the pads. The point-of- contact shall be notified if there is a recall by the manufacturer of either the batteries or the pads. This notification shall be documented;

4.1.14.6 The Contractor shall be responsible for notifying the designated point-of-contact for each defibrillator if the defibrillator is no longer usable (e.g. signal light not blinking, service alarm sounding, batteries or pads expired, etc.). Such notification shall be documented. The designated point-of-contact is responsible for replacing the batteries and/or removing the defibrillator from service; the Contractor is not responsible for ensuring the defibrillator is physically removed from service until it is again usable;

4.1.14.7 Coordinate an Annual AED AFRC Committee composed of

members from Code 720 (Safety), Code 240 (Security) and the AED Coordinator;

4.1.14.8 Coordinate the acquisition and/or exchange of AEDs in designated areas. Contractor will not be responsible for funding the acquisition of the AEDs. AED Coordinator will provide suggested list to Chief Medical Officer for review and approval;

4.1.14.9 Provide AED/First Aid/CPR training in support of AFRC occupational requirements, missions and projects.

4.1.15 Emergency, Pandemic and Disaster Response

The Contractor will provide Emergency, Pandemic and Disaster Response utilizing policy guidance from the NASA:

Emergency Preparedness and Response- AFOP-8715.3, Emergency Action Plan (for bldg. 703)- AFOP-8710.1, and Center Mishap Preparedness- AFPL-8621.01. In addition, the Contractor will also follow all guidance provide by NASA’s Office of the Chief Medical Officer (OCHMO) regarding any emergency, pandemic and/or disaster response.

4.1.15.1 Participate in Emergency and Disaster Response Exercises

4.1.15.1.1 Arrange and participate in emergency response

exercises (i.e. “Mock Codes”), on a quarterly basis at a minimum. These “Mock Codes” shall ensure the Health Unit staff is proficient at:

4.1.15.2 Identifying the location of an emergency (when outside the Health Unit);

4.1.15.3 Retrieving the required emergency response supplies;

4.1.15.4 Conducting Basic Life Support (BLS);

4.1.15.5 Calling for, and ensuring follow-on response, e.g. paramedic ambulance response service, is initiated; and

4.1.15.6 Conducting the initial steps of Advanced Cardiovascular Life Support (ACLS), such as applying oxygen, starting an intravenous line, placing a cardiac monitor, and recognizing “shockable” from “non-shockable” cardiac rhythms.

4.1.16 Participate in other exercises (e.g. aircraft mishap exercises, earthquake drills, mass casualty exercise, etc.) when scheduled, or as directed by the COR. Health Unit staff shall participate in After- Action Reviews, or other such performance review mechanisms (e.g.

monthly staff meetings) as required, or as directed by the Chief Medical Officer.

4.1.17 Contractor will provide training required to AFRC personnel and contractors in Cardiopulmonary Resuscitation (CPR) and First- Aid/Automated External Defibrillation, in accordance with the standards of the American Heart Association to all employees required by their position and job related activities (e.g. Employees within the Blood Borne Pathogen Program, Safety, Security, etc.).

Training will be scheduled and provided at the AFRC Main Campus, and at Building 703 in Palmdale on a regular basis. In addition, the contractor will also provide CPR/AED/First Aid training to other AFRC personnel and contractors monthly at AFRC and/or bldg. 703.

4.1.17.1 The Government shall provide the materials, e.g. books, and the equipment, e.g. manikins, to be used in the training. The Government shall also provide the supplies for cleaning the manikins after use.

4.1.17.2 The Government shall provide (i.e. pay for) the course completion cards for those successfully completing the course.

4.1.18 Participate in a structured Medical Quality Assurance and Peer Review program with the AFRC Chief Medical Officer, in which selected charts are reviewed for accuracy (i.e. “Chart Reviews”) and overall quality of care (i.e. “Peer Review”).

4.1.19 Provide a designated “Infection Control Officer” (ICO) to implement the AFRC Infection Control Plan and provide training to members of the Infection Control Workgroup.

4.1.20 Document all patient contacts in the NASA-provided electronic health record system (EHRS), and shall complete all required forms in accordance with standard practice and specific NASA guidance.

4.1.20.1 Attend meetings at the AFRC as required, or as directed by the COR.

4.1.20.2 Develop specific written standing orders and protocols for the Contractor Health Unit staff (to include the Nurse Practitioner and the Registered Nurses) to address, at a minimum, the three conditions listed below. These standing orders and protocols shall be written and signed by the Contractor’s doctor (MD or DO) (i.e. Medical Director), and must receive the written concurrence of the AFRC Chief Medical Officer prior to implementation:

4.1.20.2.1 Chest Pain;

4.1.20.2.2 Anaphylactic Reaction;

4.1.20.2.3 Initial Steps of emergency response beyond Basic Life Support (e.g. placing an intravenous line, administering oxygen, applying a cardiac monitor, etc.).

4.1.20.3 Support simulation tests and landing when required by NASA AFRC. Specific Industrial Hygiene support measures will include those functions previously described in this Performance Work Statement. The exact amount and types of services (e.g. the type of staff and the hours required) required will be determined as needed; reimbursement to the Contractor will be accomplished a separate reimbursement mechanism.

4.2 Health and Wellness

4.2.1 Contractor shall ensure All OCHMO Health and Wellness requirements, based on NPR 1800.1 and OCHMO Fitness Center audit questionnaire requirements are implemented. Managing informative poster and brochures throughout the Fitness Center regarding current health and wellness campaigns and general safety guidance.

4.3 Environmental Health (Industrial Hygiene and Health Physics), the Contractor shall:

4.3.1 Develop an Environmental Health Program Orientation Handbook with the intent to help new EH contract personnel understand the different elements of the AFRC EH programs. Draft versions of the EH Program Orientation Handbook shall be submitted to the EH program manager for review and approval.

4.3.2 Conduct Environmental Health surveillance (e.g. “exposure assessments”, surveys) of facilities, work process, projects and health hazard generating equipment (e.g.

ionizing and non-ionizing radiation, noise, etc.), materials using standard IH/HP equipment/instruments and standard IH sampling/surveillance techniques. NASA AFRC will provide equipment and supplies to support environmental surveillance.

The Contractor shall prepare, review and/or modify all standard operating procedures for conducting environmental health surveillance based on approved consensus standards and NASA requirements.

4.3.2.1 Contractor shall update individual branch codes exposure assessment summaries, annually. Initial exposure assessment summaries include a list of similar exposure groups (SEGs), what hazards each SEG is or may be exposed to, and the required training and medical surveillance programs associated with each hazard. Updates shall reflect the current EH department’s understanding of the hazards in each branch code. Updates may include (but are not limited to) adding new hazards identified, removing SEGs from certain medical monitoring programs, and an updated reproductive and development hazard chemical list. Contractor shall work with each respective branch manager, or designee, to verify all

SEGs listed are current and identified and to verify if they know of any other hazards or concerns not already listed in the exposure assessment summary. The branch code exposure assessment summary format will be provided by the NASA EH program managers. Updated exposure assessment summaries shall be approved by the NASA EH program managers prior to sending them out to the respective branch managers and other applicable personnel (e.g. other contractor safety representatives).

4.3.3 Surveillance shall be conducted on a regular schedule, as well as ad-hoc in support of specific AFRC missions or projects. Approved Survey protocols must be used by the contractor. Survey information and results will be documented using official AFRC survey forms. Upon direction by the COR, conduct or coordinate surveying or sampling of potential worksite health hazards. Routine requests shall be accomplished within thirty (30) days; urgent requests shall be accomplished within one (1) day.

4.3.3.1 Final Reports are due five (5) business days from the day the results are received at NASA AFRC. Reports will include the sampling results, analysis and recommendations, and will be provided to the HP and/or IH Program Manager for review and approval prior to providing information to AFRC customers.

4.3.4 The Contractors shall accomplish the following tasks, as applicable:

4.3.4.1 Sample various media (i.e. air, soil and/or water) for analysis;

4.3.4.2 Perform noise surveys and dosimetry. This also includes investigating non-age corrected standard threshold shifts (STS), temporary threshold shifts (TTS), and age-corrected

STS;

4.3.4.3 Perform ventilation surveys;

4.3.4.4 Perform illumination surveys;

4.3.4.5 Perform ionizing radiation surveys;

4.3.4.6 Perform non-ionizing radiation surveys (to include RF and UV surveys);

4.3.4.7 Monitor and report heat stress conditions (if necessary);

4.3.4.8 Reproductive and Developmental hazard surveys;

4.3.4.9 Perform Ergonomic surveys;

4.3.4.10 Indoor Air Quality Survey; and

4.3.4.11 Compliance surveys.

4.3.5 Conduct internal reviews (i.e. “program self-assessments”), within twelve (12) months of being scheduled. The self-assessments shall include the following areas:

4.3.5.1 Asbestos;

4.3.5.2 Hearing Conservation and Noise;

4.3.5.3 Cryogens;

4.3.5.4 Hexavalent Chromium;

4.3.5.5 Lead;

4.3.5.6 Hazard Communication (Global Harmonization System);

4.3.5.7 Non-Ionizing (Radiofrequency and Microwave) Radiation);

4.3.5.8 Ionizing Radiation;

4.3.5.9 Laser and High Radiant Optical Device Safety;

4.3.5.10 UV Safety Program;

4.3.5.11 Respiratory Protection;

4.3.5.12 Local Exhaust Ventilation;

4.3.5.13 Blood-Borne Pathogens;

4.3.5.14 Thermal Stress;

4.3.5.15 Ergonomics;

4.3.5.16 Heavy Metals (as appropriate);

4.3.5.17 Reproductive and Developmental Hazard program;

4.3.5.18 Hydrazine Program; and

4.3.5.19 Any other OSHA specific health hazard that may be present in the AFRC workplace.

4.3.6 Maintain an inventory of all IH/HP sampling/surveillance equipment. Contractor will ensure associated equipment logs are completed and maintained.

4.3.6.1 Perform routine field calibration, and ensure all instruments receive respective calibration in accordance with the manufacturer’s recommended schedules.

4.3.6.2 Perform monthly “bump” test for all ionizing radiation survey equipment using check sources and radio-frequency meter using a two-way radio.

4.3.6.3 Record all bump test.

4.3.6.4 Contractor will coordinate with NASA metrology and/or vendor for instruments that will require outside calibrations.

Including shipment of instruments.

4.3.7 Coordinate with NASA and outside vendors to provide health, and environmental analytical laboratory services for sampled items. Contractor will coordinate with NASA’s logistics for the shipment of such samples. These services will be at the Government’s expense, and shall be coordinated through the COR.

4.3.8 Food Safety Program-The Environmental Health Staff will conduct a Semi-annual document review of Food Safety Inspections performed by the Edwards Air Force Base Food Inspectors for the Cafeteria in Building 4825. In addition, the contractor will also evaluate all other food related programs as identified in the NPR 1800.1.

Documentation of such review will be placed in the AFRC I drive. EH Contract will perform the OCHMO required annual self-reviews and will participate in the AFRC Tri-annual OCHMO audit.

4.3.9 Provide technical consultation services, including reviewing and commenting on various technical documents (e.g. Chemical Purchase Reviews, project plan reviews) concerning proposed construction projects, aircraft research projects, or other projects, for compliance with applicable IH/HP requirements. These reviews shall be accomplished within 10 business days of request.

4.3.10 Support the implementation, compliance and…