Attachment 1_PWS as Rev10_04072022.pdf

US Department of Agriculture (USDA)

Performance Work Statement

Contents Project Title General Information

1.0 Background and Purpose

2.0 Definitions

Contractor Requirements

3.0 Technical Requirements / Tasks

4.0 Deliverable / Schedule

5.0 Government Furnished

6.0 Travel

7.0 Training

8.0 Contractor’s Key Personnel

9.0 Security Requirements

10.0 Data Rights

11.0 Section 508 - Electronic and Information Technology Standards

12.0 Quality Control Plan

13.0 Performance Requirement Measures

Attachments and Appendices

Project Title USFS Medical Qualifications for Wildland Firefighters

General Information

1.0 Background and Purpose

The requirement to meet minimum Interagency Wildland Firefighter Medical Standards is a condition of employment for many Forest Service employees and a critical element to performing the full range of essential arduous duties and responsibilities safely and efficiently. In accordance with 5 CFR 339, the U.S. Department of Agriculture, Forest Service, and Department of Interior have developed Office of Personnel Management approved medical standards to address the arduous and hazardous occupational, functional, and environmental requirements of wildland firefighting positions. The Medical Qualifications Program establishes the minimum medical requirements considered necessary for safe and efficient performance of the full range of essential functions and ensure medical expectations are applied consistently and uniformly to all applicants and incumbents.

5 CFR 339.205 Medical Qualification Program provides for the establishment of periodic examinations to safeguard the health of employees whose work may subject them or others to significant health or safety risks due to occupational or environmental exposure or demands. More information on Medical standards can be found on the USFS eMedical Qualifications website:

https://www.fs.usda.gov/managing-land/fire/safety/emedical

The general scope of the contract will include the following services for USFS incumbents and applicants in all US States and Territories.

• Arduous Medical Exams (Triennial) (Appendix A)

• OF-178 Exams (Periodic) (Appendix A)

• HIPAA Privacy & Security Rule and FIPS compliant electronic Medical Record utilization

The goal of this contract is to obtain timely access to standardized, quality occupational medical exam services on a nationwide scale and accurate and secure records of these medical exams for all USFS positions requiring such.

Additionally, exams will be input, stored, and tracked within the USDA’s eMedical information system. Medical Provider services will be identified and procured by the Contractor, scheduled through the contractor, and payment arranged through the contractor.

2.0 Definitions

Arduous Medical Exam: A mandatory triennial medical examination of a current or new employee to determine whether the employee is physically and psychologically able to safely perform the essential functions of the wildland firefighter at an arduous level. May also be required when an employee has a change in health status, such as after a serious illness or injury.

OF-178 Exam: A medical examination of a current or new employee to determine whether the employee is physically or psychologically able to safely perform the essential functions of the wildland firefighter at a light or moderate level. May also be required when an employee has a change in health status, such as after a serious illness or injury.

eMedical: The HIPAA compliant, password protected, access logged, web-based information system that collects, tracks, and stores the medical qualification information and status of wildland fire personnel.

HIPAA Privacy Rule: Standards for Privacy of Individually Identifiable Health Information, establishes national standards for the protection of certain health information. Reference 45 CFR Parts 160 and 164 Standards for Privacy of Individually Identifiable Health Information; Final Rule.

HIPAA Security Rule: Security Standards for the Protection of Electronic Protected Health Information (the Security Rule) establish a national set of security standards for protecting certain health information that is held or transferred in electronic form. The Security Rule operationalizes the protections contained in the Privacy Rule by addressing the technical and non-technical safeguards that organizations called “covered entities” must put in place to secure an individual’s “electronic protected health information” (e-PHI). Reference 45 CFR Parts 160, 162, and 164 Health Insurance Reform: Security Standards; Final Rule.

Key personnel: Includes Contract Program Manager (CPM) at least one alternate CPM, and one Deputy Program Manager assigned for each identified Forest Service Region.

Medical Provider: Must be a:

1. Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.) with a current, active, unencumbered medical license in a state, territory, or Commonwealth of the U.S.

2. Advanced Practice Registered Nurse (APRN) with appropriate national board certifications (ANCC or AANP) as a Nurse

Practitioner and a current, active, unencumbered nursing license in a state, territory, or Commonwealth of the U.S.

3. Physician’s Assistant (PA) with appropriate board certifications (AAPA) and a current, active, unencumbered license for a state, territory, or Commonwealth of the U.S.

Medical Qualifications Program: A USDA program that determines medical qualification either against established medical standards for positions where duties are arduous and hazardous or require a certain level of health and/or fitness because the nature of the position involve a high degree of responsibility toward the public or sensitive national security concerns. Reference the latest version of 5 CFR 339.202.

Performance Requirement: The point that divides acceptable and unacceptable performance of a task according to the PRS and the Inspection of Services clause. It is the number of defects or maximum percentage of defects in the lot that is acceptable.

Performance Requirements Summary: A listing of the service outputs under the contract that are to be evaluated by the COR on a regular basis, the surveillance methods to be used for these outputs, and the performance requirement of the listed outputs.

Protected Health Information: Any individually identifiable health information held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. Individually identifiable health information, includes demographic data that relates to:

• the individual’s past, present, or future physical or mental health or condition,

• the provision of health care to the individual, or

• the past, present, or future payment for the provision of health care to the individual, and that identifies the individual or for which there is a reasonable basis to believe can be used to identify the individual.

Quality Assurance: A planned and systematic pattern of all government actions necessary to provide confidence that adequate technical requirements are established; products and services conform to established technical requirements; and satisfactory performance is achieved.

Quality Control: Those actions taken by a contractor to control the production of outputs to ensure that they conform to the contract requirements.

Quarter: For evaluation, review and tracking purposes the following dates will be utilized to define contract quarter parameters:

1st quarter: June 1-August 31 2nd quarter: September 1 -November 30 3rd quarter: December 1-Feb 28 4th Quarter: March 1-May 31

Record: Any item, collection, or grouping of information about an individual that is maintained by agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and that contains the person’s name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a fingerprint or voiceprint or a photograph.

Reviewing Medical Officer: Agency designated employee responsible for determining medical qualification status of fire personnel based on exam results and information obtained from medical provider and examinee.

Statistical Random Sampling: a sampling method where each service output in a lot has an equal chance of being selected for quality assurance surveillance.

Sample: A sample consists of one or more service outputs drawn from a lot for quality assurance

Security Incident - means an event that has, or could have, resulted in unauthorized access, modification, loss or damage to government assets, or sensitive information, or an action that breaches security requirements of the contract.

ACRONYMS

AMP – Arduous Medical Process CO – Contracting Officer COR – Contracting Officer Representative CPM -- Contracting Program Manager DPM – Deputy Program Manager ePHI – electronic Personal Health Information HIPAA -- Health Insurance Portability and Accountability Act HSQC – Health Screening Questionnaire Coordinator LHCP -- Licensed Health Care Provider MP – Medical Provider MQP – Medical Qualifications Program PII – Personally Identifiable Information PIV – Personal Identity Verification PHI – Protected Health Information PRS -- Performance Requirements Summary RMO – Reviewing Medical Officer USDA – United States Department of Agriculture USFS – United States Forest Service

Contractor Requirements

3.0 Technical Requirements / Tasks

The Contractor shall:

1. Identify and deliver services from medical providers (meeting licensing requirements defined above) on a national scale to perform AMP and OF-178 exams within a 50 road mile radius of identified USFS wildland fire personnel duty stations.

2. If unable to locate acceptable MP within 50 mile road radius of any USFS station to provide all exam components, shall identify alternate means of delivering cost-effective medical services to USFS personnel and contact COR within five business days with solution.

3. Train MP’s in the use of the USFS eMedical system and ensure utilization of eMedical to input exams results.

4. Provide support to MP’s for all scheduling, payment, tracking, and medical record training and access issues.

5. Responsive to MP’s for access-related issues (i.e. username/password/data entry support).

6. Provide multiple methods to access customer support (e.g., phone, email, chat, web portal) for common inquiries during business hours.

7. Assist USFS Wildland fire personnel in scheduling exams with pre-identified MP’s within 5 business days of examinee request

8. Track all exams, completed and missed. Missed exams are defined as those canceled by employee/supervisor with less than 2 business days advance notice to contractor or those arrived at more than 30 minutes past scheduled time.

The employee may cancel the scheduled physical examination within 2 business days prior to the appointment date with no penalty or charges assessed to the Government. If the Contractor is not notified of a cancellation within 2 business days prior to the scheduled appointment date, the Contractor may invoice for the missed appointment at a rate not to exceed $50 per individual appointment. If the Contractor needs to reschedule a physical examination testing appointment, the Contractor shall notify the employee within 5 business days prior to the appointment date and shall establish a new appointment date. The Government will not incur any charges associated with Contractor rescheduling. The government estimates that there will be 10 missed appointments per quarter.

9. Ensure MP’s complete all components of the requested examination type and any ancillary, as-needed services ordered, as outlined and defined in Appendix A.

10. Ensure MP’s have required equipment to perform exam components, as indicated in Appendix A.

11. Ensure MP’s accurately input exam results into eMedical system and submit to MQP for review by RMO’s

12. Provide timely payment to the exam provider, invoice the government for all medical exam services scheduled under this contract and ensure no personal insurance information or payment is collected from examinees scheduled under this contract. Any unauthorized billing of examinees will be resolved within seven (7) business days of notification.

13. Provide all personnel, equipment, tools, materials, supervision and other items and services necessary to perform Medical

Exam Services for positions with specific medical standards and/or physical requirements pursuant to 5 CFR Part 339 as well as contract terms and conditions. The Contractor shall adhere to the current and latest version of 5 CFR Part 339 and all regulations included herein.

14. Provide a total compensation plan setting forth proposed salaries and fringe benefits for professional employees working on the contract. Include supporting information, such as compensation surveys, used in establishing the total compensation structure. Compensation Plan should reference position classifications, not individuals. Reference Provision FAR 52.222-46.

4.0 Deliverable / Schedule

Key Deliverables—Must be compatible with Microsoft Office 365

Item No. Deliverable Objective Due 1 Project Plan Identify methods to select, recruit, orient, monitor, maintain, and pay quality Medical Providers. Identify alternate plan for providing exams and medical services to locations where MP’s are not found within 50 road miles radius. Identify Compensation Plan per FAR 52.222-46

Proposal Plan

2 Proposed timeline of Plan

Identify timeline for item #1 Proposal Plan

3 Implementation of Project Plan

MP’s are recruited, trained and available to implement plan in Regions 8, 9 ,10 and smokejumper bases (reference Attachment C).

Approximately 4000 arduous personnel.

Provide Status update and complete list of MP’s to COR 2 weeks prior to implementation, as indicated in QASP.

Implementation of AMP August 1, 2022 (subject to change)

4 Implementation of Project Plan

MP’s are recruited, trained and available to implement plan in Region 6 (reference Attachment C).

Approximately 4000 arduous personnel.

Status update and complete list of MP’s provided to COR 2 weeks prior to implementation, as indicated in QASP.

Implementation of AMP January 1, 2023 (subject to change)

5 Implementation of Project Plan

MP’s are recruited, trained and available to implement plan in Region5 (reference Attachment C).

Approximately 6400 arduous personnel.

Implementation of AMP August 1, 2023 (subject to change)

Provide Status update and complete list of MP’s to COR 2 weeks prior to implementation, as indicated in QASP.

6 Implementation of Project Plan

MP’s are recruited, trained and available to implement plan in Regions 1 and 3 (reference Attachment C).

Approximately 5,000 arduous personnel.

Provide status update and complete list of MP’s to COR 2 weeks prior to implementation, as indicated in QASP.

Implementation of AMP January 1, 2024 (subject to change)

7 Implementation of Project Plan

MP’s are recruited, trained and available to implement plan in Regions 2 and 4 (reference Attachment C).

Approximately 4300 arduous personnel Provide complete list of MP’s to COR 2 weeks prior to implementation, as indicated in QASP.

Implementation of AMP January 1, 2025 (subject to change)

8 Monthly Status Report Report documenting tasks, updates & issues, and actual workload data monthly. Includes number of exams scheduled, completed, missed, etc.

Monthly, last Friday of each month, by 3:00 PM EDST until the contract expires beginning August 1, 2022

9 Performance Evaluation Meetings

Performance of service will be evaluated using QASP to determine whether or not it meets the performance requirements of the contract

Quarterly, as schedule by COR

10 Task Tracking Management System

Access to system to update on timelines, workflow status, action items, etc.

As requested by COR, within 3 business days of request

11 Ad Hoc Reports i.e trending systemic problems with eMedical, repeated non-compliance with one or more MP, etc) estimated at 4 reports annually

As requested by COR, Within 10 business days of request

12 Transition Plan Identify and outline a plan for phasing and transitioning services and information back to the Government. Includes return of all Government furnished property and equipment.

6 months prior to the end of the contract

13 Quality Control Plan Includes the monitoring, measuring, and evaluating of quality while services are ongoing to assure performance standards and adequate oversight of MP’s are met.

10 business days after notification of award

5.0 Government Furnished

eMedical System requirements – Government will provide access to, maintenance of, training on, and updates to the eMedical system for the contractor. Use of a government-furnished PIV card and/or laptop will be required.

6.0 Travel

Essential travel will be determined at the Order Level after approval of the Contracting Officer of each Order. All travel shall be in accordance with FAR 31.205-46(a)(2), Travel costs and the Federal Travel Regulation (FTR) prescribed by the GSA in effect at the time travel occurs.

7.0 Training

Government will provide initial training to CPM (and alternate(s)) on use and navigation of eMedical system via Microsoft Teams prior to project implementation. Additional training on system updates may be necessary periodically and will be scheduled on an as-needed basis. CPM is responsible for ensuring MP’s are fully trained in eMedical access and data entry.

8.0 Contractor’s Key Personnel

The contractor shall provide a CPM who will be responsible for the performance of the work. The name of this person, and an alternate or alternates who may act for the contractor when the manager is absent, must be designated in writing to the CO.

The contractor shall be responsible for employing technically qualified personnel to perform the services required by this contract.

The contractor shall maintain the personnel, organizational, and administrative control necessary to ensure the work delivered meets the contract requirements.

The contractor shall provide a compensation plan for personnel as outlined above in 3.0 Technical Requirements.

The CPM and/or alternate shall have full authority to act for the contractor on all matters relating to daily operations.

The CPM and alternate(s) must be able to read, write, speak, and understand English.

The CPM and DPM shall be available to respond to critical contract management concerns and responsive to designated government personnel and MP’s within the same business day. For concerns brought forward after normal duty hours, the manager or alternate must be available within the next business day of the expressed concern.

Performance of services will not be required on federally recognized holidays: New Year’s Day, Martin Luther King Day, President’s Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day, and Christmas Day.

In the event the Contractor makes substitutions of key personnel, the Contractor shall notify the CO within three business days after the occurrence necessitating the substitution. Notification to the CO must include an explanation of the circumstances that necessitate the proposed substitution and documentation that the proposed substitute possesses the necessary qualifications to meet the requirements of the PWS. After the initial notification, the Contractor shall submit the information to the CO at least fifteen calendar days prior to making any permanent replacements. The contractor has 15 calendar days to identify and notify the CO of proposed qualified personnel replacement.

The CO will notify the Contractor within five days after receipt of all required substitute's personnel information of any concerns regarding the replacement.

The contractor shall ensure employees and contractors have current and valid professional certifications before starting work under this contract. Specifically reference MP credentialing under Section 2.0: Medical Providers.

The Contractor shall not employ:

• Any person or entity previously debarred, suspended or otherwise declared ineligible from participating in government programs and/or procurement processes

• Any person who is an employee of the US Government if employing that person would create a conflict of interest.

• Any person who is an employee of the Department of Agriculture, unless such person seeks and receives approval according to 18 U.S.C. 207(a).

• Any person on the U.S. Department of Health and Human Services Office of the Inspector General’s List of Excluded

Individual/Entities (LEIE).

9.0 Security Requirements

The contractor shall ensure all subcontractors/agents to whom the Contractor provides or receives ePHI agrees to follow the most updated versions of all applicable laws and regulations to secure PHI, including the HIPAA Security and Privacy Rules. Reference 45 CFR Parts 160 and 164 Standards for Privacy of Individually Identifiable Health Information; Final Rule. Reference 45 CFR Parts 160, 162, and 164 Health Insurance Reform: Security Standards; Final Rule.

The Contractor shall properly protect all information used, gathered, or developed as a result of this work. All Information Security Incidents must be reported in accordance with the requirements of the HIPAA breach Notification Rule 45 CFR 164.400-414, USDA Departmental Regulation 3505-005, even if it is believed the incident may be limited, small, or insignificant. USDA will determine when an incident requires additional focus and attention.

In order to access Forest Service Information Technology (FS IT) systems, non-Forest Service employees may need to have an identity record input in the Person Model database (USDA's identity management system). Contractor shall adhere to any protocols necessitated by the contract they are Assigned in Person Model and holding and maintaining an USDA HSPD12 credential. May require background checks and additional training.

10.0 Data Rights

The CPM (and alternate) shall have access to some eMedical administrative permissions determined by the MQP staff but cannot change, edit, alter any PII or PHI. Medical Providers will have Provider-level access to view some examinee data and input exam results. All data created and stored within eMedical, and for use of the MQP, is the sole property of the United States Federal Government.

11.0 Section 508 - Electronic and Information Technology Standards

Section 508 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794d), requires Federal agencies to develop, procure, maintain, or use electronic and information technology (EIT) that allows Federal employees and members of the public with disabilities to have access to and use of information and data that is comparable to other Federal employees or individuals without disabilities.

CPM shall have basic access to eMedical with intent to provide MP’s training and support for access-related issues (i.e.

username/password/data entry support). Any and all systemic changes or concerns in eMedical will be handled by designated MQP personnel. In the event the CPM and/or MP’s experience systemic problems outside of basic access difficulties, or outside of scope of access, inform MPQ designated personnel.

In order to access Forest Service Information Technology (FS IT) systems, non-Forest Service employees may need to have an identity record input in the Person Model database (USDA's identity management system). Contractor will adhere to any protocols in regard to the contract they are Assigned in Person Model and holding and maintaining an USDA HSPD12 credential. May require background checks and additional training.

(a)Any system, hardware, software, firmware or networked component (voice, video or data) developed, procured or acquired in support or performance of this contract shall be capable of transmitting, receiving, processing, forwarding and storing digital information across system boundaries utilizing system packets that are formatted in accordance with commercial standards of Internet Protocol (IP) version 6 (IPv6) as set forth in the USGv6 Profile (NIST Special Publication 500-267) and corresponding declarations of conformance defined in the USGv6 Test Program. In addition, this system shall maintain interoperability with IPv4 systems and provide at least the same level of performance and reliability capabilities of IPv4 products: (b)Specifically, any new IP product or system developed, acquired, or produced must: (1) Interoperate with both IPv6 and IPv4 systems and products, and (2) Have available contractor/vendor IPv6 technical support for development and implementation and fielded product management. (c) As IPv6 evolves, the Contractor commits to upgrading or providing an appropriate migration path for each item developed, delivered or utilized at no additional cost to the Government. (d) The Contractor shall provide technical support for both IPv4 and IPv6.

(b)(e) Any system or software must be able to operate on networks supporting IPv4, IPv6 or one that supports both. (f) Any product whose non-compliance is discovered and made known to the Contractor within one year after acceptance shall be upgraded, modified or replaced to bring it into compliance at no additional cost to the Government.

12.0 Quality Control Plan

The Contractor shall outline how quality control will be monitored and maintained for all work under the contract.

The Contractor, not the Government, is responsible for management and quality control actions to meet the terms of this contract. The role of the Government is quality assurance to ensure contract standards are met. The Contractor shall provide a Quality Control Plan (QCP) due 10 business days after award notification for review and comments. The Contractor shall supplement the QCP before beginning work based on items awarded to the Contractor and Government comments and on an as-needed basis.

The general Quality Control Plan must demonstrate how the Contractor will assure quality meets the requirements of the contract. It shall specify how quality will be monitored to assure the performance standards are met as well as the oversight of MP’s. Quality control includes the monitoring, measuring, and evaluating of quality while services are ongoing. The Contractor shall not rely on the Government inspection for their quality control.

13.0 Performance Requirement Measures

Performance Objective Required Task or Deliverable

Performance Standard Method of Surveillance

Exam Scheduling Within 5 business days of examinee request

No more than 25 complaints per quarter

Validated customer complaints

Exam Completion AMP or OF-178 Exam performed

90% of MP’s under contract will perform exam statistical random sampling by

COR

Utilization of eMedical system to accurately and completely input, store, and track exam results in agreement with PWS 3.8

Within 5 business days of exam completion

No more than 25 missing or late exam results input per quarter statistical random sampling by

COR

Facilitate payment for exam services

No personal insurance information or payment is collected from examinees

No more than 25 complaints per quarter

Validated Customer Complaints

Inform MQP Point of contact of systemic errors within eMedical

Within 48 hours of notification to contractor

100% Validated Customer Complaints

Attachments and Appendices

Attachment A (separate document, externally attached) is the Arduous Medical Exam components. Parts A and B are pre-exam requirements, completed by examinee and agency officials. Part C is to be completed by MP.

Attachment B (separate document, externally attached) is the OF-178 Exam components. Parts A and B are pre-exam requirements, completed by examinee and agency officials. Part C is to be completed by MP.

Attachment C: Regional maps and Duty Station location spreadsheet.

Appendix A: Medical Exam Types and required Components

The types of exams and the required components of each to be offered under this contract detailed in this Technical Appendix.

1. Arduous Medical Exam - *Required Components include (but not limited to):

(Performed every three years for all arduous level fire qualifications)

• Pre-examination Medical History Review (Part B of exam)

• General Physical Examination (including vital signs such as height, weight, blood pressure, pulse, respirations and temperature)

• Hearing Test (without aids): Audiogram (minimum includes 500, 1000, 2000, 3000 Hertz in both ears) (4000 Hz may be tested to extrapolate hearing/threshold at 3000 Hz) If no Audiometer is available, Whisper test is sufficient

• Visual Acuity, near and far vision (Snellen wall chart distant vision test, font size 5 near vision test), corrected and uncorrected, each eye separately, plus together; Peripheral Vision; Color Discrimination (if no Ishihara test available, red/green/yellow is sufficient). Depth perception with clinical assessment of neurologic exam

• Peak Flow

• Ability to perform EKG if indicated

• Ability to perform, or locally outsource, Chest X-Ray if indicated

• LAB testing: Dipstick UA for Glucose, SpGr, pH, Nitrites, Ketones, Blood, Protein, and Leukocytes

• Offer Tetanus vaccination booster, Td or Tdap, for examinees in need based upon the date of last vaccination

(every ten years) and document examinees vaccination or denial of vaccination.

• Review of results and certification of completeness, summary statement and proper notation for any significant findings.

2. OF-178 –*Required Components include (but not limited to):

(performed as-needed/requested by Agency personnel for moderate and light level fire qualifications)

• Pre-examination Medical History Review

• General Physical Examination (including vital signs such as height, weight, blood pressure and pulse)

• Hearing test (without aids): Audiogram (including 500, 1000, 2000, 3000 Hertz in both ears) (4000 Hz may be tested to extrapolate hearing/threshold at 3000 Hz) If no Audiometer is available, Whisper test is sufficient

• Visual Acuity, far vision (Snellen wall chart distant vision test), Jaeger no.2 near vision test, corrected and uncorrected, each eye separately; Peripheral Vision; Color Discrimination, if no Ishihara test available, red/green/yellow is sufficient. Depth perception if available

• Ability to perform EKG if indicated

• Ability to perform, or locally outsource, Chest X-Ray if indicated

• LAB testing: Dipstick UA for SpGr, Sugar, Blood, Albumen/protein, Leukocytes

• Review of results and certification of completeness, summary statement and proper notation for any significant findings.

3. As-needed (ancillary) Exam Components

• Offer Tetanus vaccination booster, Td or Tdap, for examinees in need based upon the date of last vaccination

(every ten years) and document examinees vaccination or denial of vaccination.

• Chest X-Ray

• EKG

*This list is not all-inclusive, MP must review documentation and complete all components as directed on specific exams forms.