CTR073228_Concentra_Employee_Med_Exam_Svcs_contract.pdf

Request for Proposal

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of Administration State Procurement Office

Solicitation Attachment – Offer and Acceptance | Revision No. 6 | Revised 03-24

Attachment 01 – Offer and Acceptance Form

SUBMISSION OF OFFER: The undersigned hereby offers and agrees to provide Statewide Employee Medical Exam Services in compliance with all terms, conditions, specifications, and amendments in the Solicitation and any written exceptions in the Offer indicated by the latest dated version below

CERTIFICATION: By signature in the above, Offeror certifies that it:

1. Will not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, [Arizona] State Executive

Orders 2023-09, 2023-01, 2009-09 or A.R.S. §§ 41-1461 through 41-1465;

2. Has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or Service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause will result in rejection of the Offer. Signing the Offer with a false statement will void the Offer, any resulting contract, and may be subject to legal penalties under law;

3. Complies with A.R.S. § 18-132 when offering electronics or information technology products, Services, or maintenance;

4. Has submitted this Offer as a firm offer for 180 days following the Solicitation due date and time per the Instructions to Offers. Any extensions to the Offer Acceptance Period shall be made in accordance with the A.A.C. R2-7-C310;

5. Did not and will not involve collusion or other anti-competitive practices; and

6. Is not debarred from, or otherwise prohibited from, participating in any contract awarded by federal, state, or local government.

ACCEPTANCE OF OFFER

The offer is hereby accepted.

The Contractor is now bound to sell the Materials or Services listed by the attached Contract and based upon the Solicitation, including all terms, conditions, specifications, amendments, etc., and the Contractor’s Offer as accepted by the State.

The Contract shall henceforth be referred to as Contract No.

The effective date of the Contract is

The Contractor is cautioned not to commence any billable work or to provide any Material or Service under this Contract until Contractor receives purchase order or written notice to proceed.

State of Arizona Awarded this day of 20

Francine Whittington Statewide Procurement Manager

Occupational Health Centers of the Southwest, P.A. (AZ) dba Concentra Medical Centers

Offeror company name Signature of person authorized to sign Offer Date

1818 E Sky Harbor Circle North Bldg 2 Scott A. Cole, MD, Vice President

Address Printed name and Title

Phoenix, AZ 85034 Jane Erickson, Key Account Manager

City, State, ZIP Contact name and Title jane_erickson@concentra.com 760.484.4198

Contact email address Contact phone number

Revised Offers:

Date Signature Date Signature

Best and Final Offer:

Date Signature

DocuSign Envelope ID: 2C827757-B777-44BE-BC5E-D69B7D02EEE5

6/17/2024

CTR073228

September 1, 2024

14th August 24

Scope of Work

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

1802 W. Jackson, #100

Phoenix, AZ 85007

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 5 of 68

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Scope of W ork

1.0 PURPOSE AND BACKGROUND

1.1 Purpose

The purpose of this Solicitation is to establish contracts for Statewide Medical

Exams for Eligible Agencies, Employees, and the State of Arizona. The contracts that results from this RFP may be expanded to meet further needs and it may be modified to incorporate changes in federal regulations or the State of Arizona’s policy.

1.2 Background

1.2.1 The State has a need for various medical examinations to be performed on job candidates for various job class groupings.

1.2.2 Eligible Agencies may have ongoing requirements for coordinating and reviewing medical physical exams for numerous job class groupings that put incumbents at risk of occupational illness or injury.

1.2.3 The Department of Transportation (DOT) and Arizona Peace Officer

Standard Training (AZPOST) exams that are done for initial hiring, are performed in conjunction with the General Exam referenced in Section

3.0

1.2.4 Other specific tests and exams may be ordered independent of the

General Exams by Eligible Agencies for persons already employed by different State or public entities.

1.3 Definitions

1.3.1 Commission on Laboratory Accreditation of the College of American

Pathologists (CAP): CAP accredits laboratories performing testing on specimens from human beings or animals, using methodologies and clinical application.

1.3.2 IAFF/ IAFC: International Association of Firefighters/ International

Association of Fire Chiefs.

1.3.3 IAFF/IAFC Wellness Fitness Initiative: A comprehensive wellness program that emphasizes physical, mental, and emotional well-being.

1.3.4 National Laboratory Certification Program (NLCP): Verifies laboratory procedures, data, and documentation, drawing on their extensive experience in forensic toxicology, which includes management and

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 6 of 68 bench-level experience in Department of Health and Human Services

(HHS)–certified drug testing laboratories

1.3.5 NFPA 1500: specifies the minimum requirements for an occupational safety and health program for fire departments or organizations that provide rescue, fire suppression, emergency medical services, hazardous materials mitigation, special operations, and other emergency services.

1.3.6 NFPA 1582: National Fire Protection Association (NFPA) 1582 is a concise list of requirements for medical testing and physical examinations that should be done when firefighters join the department, and each year thereafter. The list includes items such as: a physical examination, chest x-ray, and cancer screening.

1.3.7 OSHA: Occupational Safety and Health Administration

1.3.8 Substance Abuse and Mental Health Service Administration

(SAMHSA). Agency within the U.S. Department of Health and Human

Services (HHS) that leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders.

1.3.9 USDOT: US Department of Transportation

2.0 GENERAL REQUIREMENTS. The Contractor shall:

2.1 Ensure any equipment utilized by the Contractor (or Subcontractor as applicable), shall meet or exceed applicable Federal and/or industry standards and requirements for the purpose intended

2.2 Ensure that all services provided as part of this contract will be in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its subsequent amendments and changes. Any violations shall be reported immediately to ADOA in writing. The Contractor shall notify ADOA of any and all actions taken as a result of any violation.

2.3 Ensure that all forms are complete prior to transmitting to the Eligible Agency.

2.4 Notify the Eligible Agency contact immediately, if the examining professional discovers any health problems or abnormal findings. All findings are to be thoroughly documented on the exam forms provided by the Eligible Agency.

2.5 The Contractor shall not:

1. Provide follow-up medical services for any Eligible Agency’s referral.

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 7 of 68

2. Hold an exam while waiting for the candidate to provide medical information from his/her personal physician, but shall complete the exam and forward exam results to the Eligible Agency. The Agency will determine if further examinations will be required.

2.6 Perform a vaccination and/or medical mask fit test without a prior full physical on the employee if requested by the agency.

2.7 Contractor Account Representative

2.7.1 Identify and assign an Account Representative to address issues and/or concerns submitted by Eligible Agencies.

2.7.2 Address any issues and/or concerns submitted by Eligible Agencies within two (2) business days of receipt, or be subject to cancellation of the contract.

2.8 Service Sites.

2.8.1 Provide suitable equipped facilities for service provided (including mobile units).

2.8.2 The contracted services shall be available statewide. Locations where services need to be provided are, but not limited to:

1. Phoenix Metropolitan area,

2. Tucson;

3. Wickenburg;

4. Globe;

5. Holbrook;

6. Show Low;

7. Quartzsite;

8. Lake Havasu City;

9. Gila Bend;

10. Superior:

11. Fredonia;

12. Williams;

13. Payson;

14. Winslow;

15. Safford;

16. Douglas;

17. Yuma;

18. Florence;

19. Page;

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 8 of 68

20. Prescott and Prescott Valley;

21. Casa Grande;

22. Tonopah;

23. Flagstaff; and

24. Pinetop.

2.9 Staffing

2.9.1 Have an adequate number of personnel appropriately trained for the services (function/tasks/subtask) provided. Monitor and provide oversight of staff and subcontractors (if utilized)

2.9.2 Have on a Medical Case Manager/Consultant on staff

1. Medical Case Manager/Consultant is a licensed medical professional who will evaluate the exam results and provide determination to the applicable agency on the potential or current employee’s ability to perform the essential functions of the position.

2.9.3 Be responsible, and held accountable, for the ongoing training of key personnel who are involved (at the Contractor or Subcontractor level) in providing services under a resultant contract.

2.9.4 Provide technical information and assistance as required for testing

2.10 Service Records

2.10.1 Establish Eligible Agency service records and maintain the confidential record for whom services are provided.

1. All records are confidential and the contents of such may not be released to anyone except upon written consent of the Eligible

Agency.

2. Should a candidate request such information, the Contractor shall refer them to the Eligible Agency.

2.10.2 The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are advising Contractors not to provide any genetic information when responding to the request for medical information. "Genetic information," as defined by GINA, includes an individual's family medical history, the results of an individual's or family member's genetic tests, the fact that an individual or an individual's family member sought or received genetic services, and genetic information of a fetus carried by an

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 9 of 68 individual or an individual's family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services.

2.10.3 Provide the original service case record to Agency within two (2) business days upon request from Agency; retain a copy of the requested service case record.

2.10.4 Retain case file for a period of two years, or per requirements of the

Eligible Agency, whichever is the longest.

2.10.5 Data obtained by the Contractor through the course of these examinations may be used only in aggregate form and may not identify candidates by name, age, gender, race, color or national origin, or groups of persons as candidates for employment or employed individuals within the Eligible Agency.

3.0 SPECIFIC REQUIREMENTS. The Contractor shall:

3.1 Appointments

3.1.1 Be able to accommodate appointments for candidates within three (3) working days of the initial request for an appointment.

3.1.2 Appointment time shall be booked and held on time. A Contractor shall not overbooked when the Eligible Agency calls to schedule an appointment;

3.1.3 Barring walk-in emergencies, and provided the candidate arrives on time, exams for candidates who have an appointment shall begin within thirty

(30) to sixty (60) minutes of the candidate’s scheduled appointment time;

3.2 General Medical Exams

3.2.1 Ensure that the General Medical Exams consist of a general health history intake completed by the individual and reviewed by the practitioner; a through Physical Examination; and other components as necessary, such as Pulmonary Function Test (PFT), liver enzymes, fitness for duty, etc., depending on the job requirements.

3.2.2 Health History. Have the individual complete a health history form. The health history may include information about allergies, illnesses, surgeries, immunizations, and results of physical exams and tests. It may also include information about medicines taken and health habits, such as diet and exercise.

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 10 of 68

1. The health history section of the exam form begins on the first page of the form and concludes at the job candidate’s agreement and signature.

2. Review the health history form to assess previous and existing health issues.

3. Discuss areas of concern with the individual and then proceed with the general exam.

3.2.3 General Medical Exams

1. Perform a thorough examination and medical review of all requirements listed on the form. Each section of the form shall be completed with comments and initials as per the form instructions.

2. The general exam shall be performed by a State Certified examining professional and shall include, but is not limited to, the following requirement:

a. Height, weight, vital signs and blood pressure;

1) If the blood pressure reading is above 140/90 it shall be noted, retested and recorded at least two more times before the individual leaves the clinic;

b. A Musculoskeletal exam, which shall include an inspection of the range of motion of joints, hands, knees, feet and spine; and testing for strength, sensation and reflexes;

1) If the Contractor prefers an on-site licensed physical therapist to do the musculoskeletal section of the evaluation, there shall be no extra charge to the Eligible Agency and the examining professional must review and sign off on the evaluation.

2) If the examining professional believes the candidate should have a lifting evaluation or functional capacity exam to determine an individual’s ability to lift, carry, push and pull the weight required to perform essential job functions, this should be reported to the Eligible Agency. The Contractor is not authorized to do such an evaluation unless specifically directed by the Eligible Agency.

c. A Dip-stick urinalysis

1) A finger stick blood test for glucose shall be done if any trace amount or greater is shown on the dip-stick, as indicated in the

General Exam form.

d. A vision test, in accordance with the General Exam form

e. A hearing test, in accordance with the General Exam form

f. Lab testing as required by the Eligible Agency

3.2.4 A Pulmonary Function Test (FVC, FEV1 and FVC/FEV1 ratio), in accordance with the Eligible Agency requirements (See Section 3.4.4).

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 11 of 68

3.3 Specialized Medical Exams

3.3.1 Firefighter Exams. Ensure the physical exam form is properly completed and signed as required at the time the exam is completed.

1. Pre-employment or Baseline Exam

a. Perform a thorough examination and medical review of all requirements per NFPA 1582 and the IAFF/IAFC Wellness

Fitness Initiative.

b. A review of all pertinent health information including full history and health examination documented on examination questionnaire form.

c. The exam shall be performed by a State Certified examining professional familiar with NFPA 1582 and shall include, but is not limited to, the following requirement:

1) Audiogram

2) Vision test: Acuity, Horizontal Field and Color Perception

3) Pulmonary Function Testing/Spirometry

4) Lab testing including:

a) Complete Blood Count and Differential

b) Lipid Panel (Total Cholesterol, HDL, LDL)

c) Liver Function Test

d) PSA

e) BUN, Creatinine

f) Urinalysis (dip)

g) Hemoglobin A1C lab test

h) BUN, Creatinine

5) Tuberculosis Skin Test

6) EKG – resting 12 lead

7) Maximal Treadmill Stress Test w/cardiologist interpretation

8) Flexibility, Fitness testing (Push-ups, plank) Body Fat

Analysis

9) PA/lateral check x-ray (2-views)

10) OSHA Respiratory Questionnaire review

2. Annual Exam

a. Perform a thorough examination and medical review of all requirements per NFPA 1582 and the IAFF/IAFC Wellness

Fitness Initiative.

b. A review of all pertinent health information including full history and health examination documented on examination questionnaire form.

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 12 of 68

c. The exam shall be performed by a State Certified examining professional familiar with NFPA 1582 and shall include, but is not limited to, the following requirement:

1) Complete physical assessment

2) Audiogram

3) Vision test: Acuity, Horizontal Field and Color Perception

4) Pulmonary Function Testing/Spirometry

5) Lab testing including

a) Complete Blood Count and Differential

b) Lipid Panel (Total Cholesterol, HDL, LDL)

c) BUN, Creatinine

d) Liver Function Test

e) Urinalysis (dip)

f) Hemoglobin A1C lab test

g) PSA

h) Blood Lead Lab Testing (Hazmat personnel)

i) HIV Testing (when requested)

6) Tuberculosis Skin Test

7) EKG – resting 12 lead

8) Treadmill Submaximal/Stepmill

9) Flexibility, Fitness testing (Push-ups, plank) Body Fat

Analysis

10) Per NFPA 1582 Risk Stratification: If risk factors conduct

Maximal Stress Testing for over 40 years of age.

11) PA chest x-ray (per NFPA as medically indicated)

12) OSHA Respiratory Questionnaire review

13) Hazmat Questionnaire (if applicable)

3. Firefighter Return to Work Exam.

a. Return to work evaluation in compliance with NFPA 1500.

3.3.2 USDOT Commercial Driver License Exam. Ensure a physical exam form or the USDOT Medical Examination Report form is properly completed and signed as required at the time the exam is completed.

1. Ensure the Commercial Driver’s License (CDL) physical exam is per performed by a certified physician listed on the National Registry of

Certified Medical Examiners. Certified Medical Examiners may be found at https://nationalregistry.fmcsa.dot.gov/home.

https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2023-12/Medical%20Examination%20Report%20Form%20MCSA-5875%2023.pdf https://nationalregistry.fmcsa.dot.gov/home

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 13 of 68

2. Perform a thorough examination and medical review of the applicant’s history. The exam shall include, but is not limited to, the following requirement:

a. Complete physical assessment

b. Audiogram

c. Vision test: Acuity, Horizontal Field and Color Perception

d. Urinalysis (dip)

3. Urine Drug Screen (See Section 3.4.5)

a. The Contractor may collect the National Institute on Drug Abuse

(NIDA) regulated split sample urine drug screen using the Chain of Custody (COC) forms provided by the Eligible Agency, if ordered/

b. The Eligible Agency shall have the right to specify a State approved laboratory and a Medical Review Officer to receive urine drug screens. The clinic may select an appropriate State approved laboratory for processing blood work.

4. Send the USDOT exam results and card to the Eligible Agency.

a. The Contractor shall NOT give the original or a copy of the exam or card to the job candidate.

3.3.3 Arizona Peace Officer Standards Training (AZPOST) Exam: Ensure a the physical exam form or the AZPOST exam form is properly completed and signed as required at the time the exam is completed.

1. The exam shall be performed only by a Medical Doctor or Doctor of

Osteopathy whom has had at least two (2) years’ experience with pre-employment medical/physical evaluation of applicants for law enforcement positions.

2. Review with the candidate, the AZPOST Medical History

Questionnaire they have filled out.

3. Perform a thorough examination and the exam shall include, but is not limited to, the following:

a. Audiogram

b. Vision test: Acuity, Horizontal Field and Color Perception

3.3.4 Correctional Officer (CO) Fitness Testing (includes Youth and Adult

Correction Officers): Conduct a Correctional Officer Fitness exam as required by the Eligible Agency.

1. Provide Services at the Contractor’s office or other professional area provided by the Contractor.

https://post.az.gov/sites/default/files/2022-09/MedicalExaminationReport_092022.pdf https://post.az.gov/sites/default/files/2022-01/MH%20Form%20JULY%202021.pdf https://post.az.gov/sites/default/files/2022-01/MH%20Form%20JULY%202021.pdf https://corrections.az.gov/sites/default/files/documents/Co%20Applicant%20Medical%20Physical%20Requirements_10-18-22.pdf

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 14 of 68

a. In order to enhance Officer Recruitment, Eligible Agencies may request the Contractor to perform these services at the Agency’s site

b. Provide services Monday through Friday, 8:00 a.m. to 5:00 p.m.

and offer weekend testing upon request.

c. This exam will need to be conducted throughout the State, near all prison facilities to include, Phoenix, Winslow, Tucson, Safford, Douglas, Yuma and Florence.

2. Perform a thorough examination and the exam shall include, but is not limited to, the following:

a. Complete physical assessment that includes a hernia test, musculoskeletal evaluation, and Phalen’s or Tinel’s test.

b. Audiogram

c. Vision test: Acuity, Horizontal Field and Color Perception

d. Pulmonary Function test (See Section 3.4.4)

e. Laboratory test, including

1) Complete blood count

2) Liver Function test

3) Hemoglobin A1C lab test

4) BUN, Creatinine

5) Urinalysis (dip)

3. Inform those applicants who do not meet the physical fitness standards for Correctional Officer (CO) Fitness Testing immediately following the examination.

a. The appropriate medical personnel shall counsel such applicants making recommendations to assist in preparation for re-testing, if the applicant desires.

b. Any applicant who does not meet the requirements of the Eligible

Agency for medical reasons shall be allowed to correct the medical problem through his/her physician at the applicant’s expense.

c. The applicant can then present the attending physician’s report to the Contractor for the Contractor’s final determination (pass/fail);

4. Respond to questions about the fitness test being conducted only. Do not respond to or comment on any questions about the hiring process.

Direct all such inquiries to authorized Eligible Agency staff.

3.3.5 HAZWOPER Physical

1. A HAZWOPER physical is required for employees who:

a. Are exposed to hazardous substances or health hazards above the permissible exposure levels (PELs) set by OSHA;

b. Wear a respirator for 30 days or more a year;

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 15 of 68

c. Become sick from possible overexposure; or

d. Work on a HAZMAT team

2. The physical exam shall include the following:

a. Review of medical and work history

b. Comprehensive Medical Exam including assessment of abnormalities in function, agility, and strength

c. Respirator evaluation if the employee is require to wear a respirator on the job

d. Vision test: Acuity, Horizontal Field and Color Perception

a. Spirometry

b. Audiometry

c. Laboratory test:

1) Liver Function test

2) CBC

3) Urinalysis

4) Any other laboratory tests that the physician might deem necessary based on the review of the employee's medical exam results, medical history, and work history.

3.3.6 Human Performance Evaluation (HPE). An HPE compares the physical abilities of a potential hire to the physical requirements of a job, determining whether the applicant can safely perform the essential job duties.

1. The physical exam shall include the following:

a. Review of medical and occupational work history

b. Comprehensive Medical Exam

c. An evaluation of functional tasks, such as lifting, carrying, pushing and pulling.

3.3.7 Fitness For Duty Exam - A fitness-for-duty examination is a medical exam to determine whether a current employee is physically or mentally capable of performing their job duties when the employer has a reasonable belief based on objective evidence that an employee's ability to perform essential job functions will be impaired by a medical condition or the employee will pose a direct threat due to a medical condition.

1. The physical exam shall include the following:

a. Review of medical and occupational work history

b. Comprehensive Medical Exam

c. Labs and testing as needed

2. Provider may be required to refer employee to a specialists for additional exams in order to complete the evaluation

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 16 of 68

3.4 Specialized Testing

3.4.1 Respirator Fitness Testing or Medical Particulate Mask (N95) Fit

Testing: The Federal Occupational Health and Safety Administration

(OSHA) and State OSHA Agencies require employers to fit-test workers who must wear respirators on the job (OSHA Respiratory Protection

Standard 1910.134(e), or Medical Particulate Mask (N95) mask on the job. When applicable to the exam, the Contractor shall:

1. Perform a physical assessment to determine the individual’s ability to use a respirator or N95 mask. The assessment shall include, but not be limited to:

a. An assessment of the head, neck, throat, mouth, lungs, heart, abdomen and vital signs;

b. A discussion with the individual about his/her history as disclosed on the Health History and Physical Examination portions of the

General Exam form.

2. The physician and individual shall complete and sign an OSHA

Respirator Medical Evaluation Questionnaire Standard Form

1910.134 App C, or any applicable form.

3. Review, comment and initial the Pulmonary Function Test (PFT). PFT tests are a group of 3 tests that measure how well the lungs take in and release air.

a. The PFT form must be completed and signed by the certified physician and the individual, then submitted to the Eligible

Agency;

4. Provide a written statement of the individual’s ability to use a respirator or N95 mask, using form provided by the Eligible Agency.

5. Perform periodic respirator physical assessments, as required by the

Eligible Agency.

3.4.2 Asbestos Physical Assessment

1. Perform an asbestos exposure physical assessment to determine any evidence of asbestos exposure-related health problems (OSHA

Asbestos Standard 1910.1001(I)) as requested by the Eligible

Agency.

2. The physical exam shall include the following:

d. Comprehensive Medical Exam

e. Review of medical and work history

f. An OSHA Respirator medical questionnaire

a. A Chest X-Ray with B Reader

1) The x-ray must be “interpreted classified only by a B-reader, a board-eligible/certified radiologist, or an experienced physician https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppC https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppC https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppC https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1001#:~:text=Excursion%20limit.-,The%20employer%20shall%20ensure%20that%20no%20employee%20is%20exposed%20to,or%20by%20an%20equivalent%20method.&text=General.

https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1001#:~:text=Excursion%20limit.-,The%20employer%20shall%20ensure%20that%20no%20employee%20is%20exposed%20to,or%20by%20an%20equivalent%20method.&text=General.

https://www.osha.gov/sites/default/files/publications/OSHA3790.pdf

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 17 of 68 with known expertise in pneumoconiosis” (United States

Department of Labor, CFR 1910.1001 Appendix E);

2) The Contractor is to provide a preliminary (“wet read”) report within twenty-four (24) hours, followed by a radiologist report to be included with the original exam sent to the Eligible

Agency within three (3) days of completion by the examining professional.

g. Pulmonary Function Test (PFT) (See Section 3.4.4)

h. Any other laboratory tests that the physician might deem necessary based on the review of the employee's medical exam results, medical history, and work history.

3.4.3 Lead Assessment

1. Perform a physical assessment to determine any evidence of lead related health problems. The assessment shall include, but not be limited to:

a. A review, assessment and discussion with the individual his/her health history as disclosed on forms provided by the eligible agency;

b. An assessment of teeth, mouth, skin, neurological status and vital signs;

c. A blood lead and zinc protoporphyrin (ZPP) blood tests;

2. The Physician shall provide a written statement indicating any evidence of lead-related health problems in accordance with 29 CFR

OSHA1910.1025 (j).

3.4.4 Pulmonary Function Testing:

1. Perform Pulmonary Function Testing in accordance with OSHA standards and record on appropriate forms provided by the Examining

Professional.

a. Following the testing, the examining professional shall complete and sign the Employer Information and Authorization for

Respiratory Evaluation sheet provided by the hiring agency and, if applicable, return to the Eligible Agency for their Respiratory

Protection Program records.

2. A reproducible measurable graph must be provided with PFT forms.

The resulting printout must indicate date and time of most recent calibration.

3. Three (3) tests must be done (FVC, FEV1 & FVC/FEV1 ratio).

3.4.5 Audiometric Evaluations. Perform Audiometric Evaluations for existing employee if requested.

https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1025 https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1025

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 18 of 68

1. Perform a hearing test; and

2. Perform historical assessment of the results to determine if employees have experienced a standard threshold shift.

3.5 Lab Testing

3.5.1 The protocols, standards and procedures utilized for specimen collection service components shall be performed in accordance with applicable

Federal requirements that include, but are not limited to, 49 CFR Parts 40 and 384.

3.5.2 Testing Facilities

1. For DOT testing. Utilize laboratories certified by the Department of

Health and Human Services (HHS) under the National Laboratory

Certification Program (NLCP) for each specimen testing methodology performed required under this part.

2. For Non-DOT. Utilize certified laboratories that hold the following certifications or accreditations

a. Substance Abuse and Mental Health Services Administration

(SAMHSA) and/or College of American Pathologists – Forensic

Drug Testing (CAP/FTD); or

b. Clinical Laboratory Amendments (CLIA) or COLA (formerly known as Commission of Office Laboratory Accreditation).

3.5.3 Identification Process. The individual’s identification must be confirmed by the Contractor prior to the commencement of the collection process.

The Individual must provide the Contractor with an acceptable form or means by which the individual’s identification can be confirmed.

Acceptable methods of identification include:

1. Photo identification issued by a foreign or domestic government (e.g., driver's license. Identification card, U.S. military ID);

2. Positive identification by an agency representative (employee badge);

and

3.6 Employee Drug & Alcohol Testing

This section is only applicable to Offerors who provide drug and alcohol testing at their facility.

3.6.1 Adhere to all applicable state and federal procedures for the collection of testing specimens.

3.6.2 Urine Collection

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 19 of 68

1. Collect specimens for drug testing that have not been substituted, diluted, or adulterated from the Eligible Agency referred donors/clients.

2. Establish and adhere to procedures that provide for the direct observation of the collection of all specimens

3. Provide for the observation of the collection of all urine specimens by a person or persons of the same gender as the donor/client, unless the monitor is a medical professional (e.g., nurse, doctor, physician's assistant, technologist, or technician licensed).

4. Direct the individual to remove outer clothing (e.g., coveralls, jacket, coat, hat, etc.) that could be used to conceal items or substances that could be used to tamper with a specimen.

5. Specimen Identification Label

a. Indicate the individual’s name and the date of collection on the specimen container identification label.

b. Require that the individual write his/her initials on the specimen container identification label after the label is affixed to the specimen container to affirm that the individual’s name and date of collection on the specimen container identification label is accurate.

6. Custody and Control Forms

a. Utilize the Federal Drug Testing Custody & Control Form or all

Department of Transportation (DOT) mandated drug tests.

b. Contractors are prohibited from using the Federal Drug Testing

CCF for non-Federal collections.

7. Testing Results

a. Documentation and reporting of test results, whether a “positive" or "negative" screen or confirmation, shall be provided to the

Eligible Agency or its designated representative (e.g., Medical

Review Officer) using secured delivery in accordance with the

DOT or non-DOT requirement

b. Conduct immediate confirmation on all positive test results, Panel/Screen/Test utilizing gas chromatography/mass spectrometry (GC/MS), liquid chromatography/mass spectrometry

(LC/MS) or an alternative method previously approved in writing by the Eligible Agency.

3.6.3 Breath Alcohol Testing. The Contractor shall provide and utilize DOT approved evidential breath-testing devices (EBTs) and trained personnel https://www.samhsa.gov/sites/default/files/workplace/2020-fed-ccf-proof.pdf

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 20 of 68

(Breath Alcohol Technician [BAT]) necessary to conduct the DOT approved breath-testing program to detect and determine the concentration of alcohol.

1. The Breath Alcohol equipment must be DOT approved for this specific application, used and maintained (e.g., calibrated) as prescribed for the conduct of evidential breath-testing, and should provide quantitative test result (e.g., grams of alcohol per 210 liters of breath) necessary to determine the concentration of alcohol (in grams) in the individual tested.

2. All breath alcohol testing devices must be calibrated with devices approved by the National Highway Traffic Safety Administration

(NHTSA) using the adjustment procedures as required in Rule.

3. A Breath Alcohol Technician (BAT) must be certified to operate and read a breath analyzer or similar testing machine that will be utilized when performing the actual test.

4. A Eligible Agency reserves the right to utilize its own approved equipment (device) and certified Breath Alcohol Technician personnel

(employee/consultant) for the conduct of these

3.7 Additional Services

3.7.1 Rabies Treatment

1. Provide all necessary equipment, supplies and administration of a

Rabies vaccination program, including pre-exposure vaccinations, titer checks, booster shots and post-exposure treatments.

2. Services shall be administered in accordance with applicable OSHA regulations and safe medical and/or nursing practices, as well as performed by appropriately licensed professionals.

3. Limit pre-exposure vaccinations to those employees designated in writing by the appointed Eligible Agency representative.

4. Document the services provided, and provide such documentation to the Eligible Agency Coordinator within thirty (30) days of performing the Service. Documentation shall include the following information:

a. The name of the employee receiving the treatment.

b. The date the initial vaccine or test was given.

c. Scheduled dates for subsequent vaccinations or tests when applicable.

d. Name of the person administering the treatment.

e. Type of treatment (titer, vaccination, booster, post-exposure).

f. Manufacturer and lot number of the vaccine used.

g. Written notification when vaccine series is complete.

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 21 of 68

5. Contractor must ensure that results of titer checks are provided to the

Eligible Agency Coordinator within thirty (30) days. Services are not considered as rendered and invoices will not be paid until this documentation is received.

6. For the AZ State Laboratory agency - Serum collection for rabies titer testing is to be collected by the medical facility and given to the patient for delivery to ASPHL so that ASPHL may arrange third party titer testing.

3.7.2 Arizona State Laboratory additional needs

1. Emerging Infectious Disease Vaccination Services - Provide vaccination services and when necessary. Work with the CDC Drug

Service to obtain the vaccine along with provided necessary documentation for tracking the vaccine from the CDC Drug Service.

2. Post exposure evaluation, treatment and prophylaxis services

– Laboratorians putatively exposed to contaminated specimens in the laboratory must be medically evaluated for appropriate post exposure prophylaxis to be administered.

3.8 Medical Reports. Due to the timely nature of medical examinations, screens and testing, expedient reporting is necessary for Eligible Agencies to make employment and placement decisions for the safety of employees and others.

Contractor shall provide any or all of the three types of reports below.

3.8.1 Written Reports: Written medical reports shall be provided within three

(3) calendar days of the service. Reports for any of the examinations or evaluations will include the following:

1. Complete identification of employee, with date of birth, employee number and home address;

2. The examining professional(s) and their specialties;

3. Complaints and present illnesses;

4. Medical, social, and family history as required;

5. Physical examination and findings using establish criteria;

6. Laboratory tests, EKG and X-ray readings and results;

7. Diagnoses, if any;

8. Recommendations and discussion, if applicable and

9. Disqualifying conditions based on established criteria

3.8.2 Verbal Reports - Due to the urgency of the findings for an Eligible

Agency for employment decisions, verbal reports may be required.

Verbal reports shall be provided to a specific authorized contact within twenty-four (24) hours of the services.

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 22 of 68

3.8.3 Document Reports – Upon request, Contractor shall submit written progress reports to the State. These reports shall include, at a minimum, the following:

1. Management report of current and completed projects;

2. Provide monthly expenditure and activity reports, if requested;

3. Total expenses accrued as of the report date; and

4. Overall assessment of contract status to include a description of any outstanding problems, together with the Contractor’s recommendation(s) for alternative options or corrective action.

Special Terms and Conditions

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 23 of 68

Special Terms and Conditions

The Special Terms and Conditions modify the Uniform Terms and Conditions. It can modify them by replacing, deleting, appending to, or revising the text of an existing provision or by inserting a new paragraph into an existing article. No other document modifies or adds to the Uniform Terms and Conditions, except as may subsequently be otherwise and expressly agreed and incorporated by Contract Amendment.

1. Definition of Terms: As used in the Contract, the terms listed below are defined as follows:

1.1. Acceptance: The document titled “Offer and Acceptance Form” bearing the state contract number once Procurement Officer has signed it to signify (1) State’s formal acceptance of the Accepted Offer and (2) the formation of the Contract. For clarity of intent, the foregoing is not to be confused with the term “acceptance” used throughout the Contract in the context of delivery, inspection, etc., with respect to Materials or Services.

1.2. Accepted Offer:

1.2.1. If State did not request a Revised Offer, then “Accepted Offer” means the

Initial Offer.

1.2.2. If State requested a Revised Offer but not a Best and Final Offer, then

“Accepted Offer” means the latest Revised Offer.

1.2.3. If State requested a Best and Final Offer, then “Accepted Offer” means the

Best and Final Offer.

1.3. Arizona Procurement Code: The Arizona Procurement Code consists of Arizona Revised

Statutes (A.R.S.) §§ 41-2501 et seq. and Arizona Administrative Code (A.A.C.) R2-7-101 et seq. There is additional information in the Solicitation Instructions regarding how to access these state statutes and rules.

1.4. Arizona Risk and Authorization Management Program (AZRAMP): is used by the Arizona

Department of Homeland Security to evaluate Cloud services and Contractors that will transfer, process, or store state data outside of state-managed or controlled networks, and has three levels of control review:

1.4.1. AZ Mandatory Control Baseline: 35 Controls

1.4.2. NIST Low Impact Control Baseline: Public Data Classification

1.4.3. NIST Moderate Impact Control Baseline: Confidential Data Classification

1.5. Arizona Transaction Privilege Tax (TPT): For information, refer to the Arizona Department of Revenue (DOR) website at: https://azdor.gov/transaction-privilege-tax-tpt

1.6. Attachment. Any item that:

https://azdor.gov/transaction-privilege-tax-tpt

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 24 of 68

1.6.1. The Solicitation required Offeror to submit as part of the Offer (e.g., Initial

Offer, Revised Offer, or Best and Final Offer);

1.6.2. Was attached to an Offer when submitted; and

1.6.3. Was included in the Accepted Offer.

1.7. Cloud Services: Cloud or Cloud Services means any Software as a Service (SaaS), Infrastructure as a Service (IaaS), or Platform as a Service (Paas) involving the transfer, processing, or storage of state Data outside the control of state-managed and controlled networks.

1.8. Contract Terms and Conditions: The Special Terms and Conditions and the Uniform

Terms and Conditions taken collectively.

1.9. Contractor: The Person identified on the Accepted Offer who has entered into the Contract with the State.

1.10. Contractor Indemnitor: Contractor or any of its owners, officers, directors, agents, employees, or Subcontractors.

1.11. Co-Op Buyer: A member of the State Purchasing Cooperative that has entered into a

“Cooperative Purchasing Agreement” with the Arizona Department of Administration State

Procurement Office under A.R.S. § 41-2632. Unless there is an applicable Cooperative

Purchasing Agreement in effect at the time, a State Purchasing Cooperative member cannot be a Co-Op Buyer. For reference, “Co-Op Buyer” is to be construed as encompassing an “eligible procurement unit” under A.A.C. R2-7-101(23).

NOTE: Membership in the State Purchasing Cooperative is open to all Arizona political subdivisions, including cities, counties, school districts, and special districts. Membership is also available to non-profit organizations, other state governments, the federal government and tribal nations. For reference, “non-profit organizations” are defined in

A.R.S. § 41-2631(4) as any nonprofit corporation as designated by the I.R.S. under

Section 501(c)(3) through 501(c)(6) of the tax code.

1.12. Data Breach: Data Breach is used herein as defined as stated in A.R.S. Title 18, chapter

5, article 4 (Data Security Breaches), or in any relevant state or federal standard, to indicate an unauthorized acquisition of and unauthorized access that materially compromises the security or confidentiality of unencrypted and unredacted computerized personal information maintained as part of a database of personal information regarding multiple individuals.

Solicitation No. BPM006197

Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

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1.13. Eligible Agency:

1.13.1. If the Special Terms and Conditions indicate that the Contract is a “single-agency” contract, then “Eligible Agency” means the particular State of Arizona agency, university, commission, or board identified therein.

1.13.2. If the Special Terms and Conditions indicate that the Contract is a mandatory statewide contract, then “Eligible Agency” means any State of Arizona department, agency, university, commission, or board.

1.13.3. If the Special Terms and Conditions indicate that the Contract is a

“cooperative” contract available for use by Co-Op Buyers, then “Eligible

Agency” means any State of Arizona department, agency, university, commission, board, or any Co-Op Buyer.

1.14. Federal Risk and Authorization Management Program (FedRAMP): A federal government program that provides a standardized approach to security assessment, authorization, and continuous monitoring specifically for Cloud products and services relied upon by federal entities that store, process and transmit federal information.

1.15. Instructions to Offerors: The Solicitation Instructions document of the Solicitation.

1.16. NIST: NIST is the National Institute of Standards and Technology. For more information, see https://www.nist.gov/.

1.17. Order: The instrument by which the Eligible Agency or Co-Op Buyer authorizes a

Contractor to perform some or all of the Work. Whether the Contract will have one Order or many Orders depends on the scope of the Contract and how the State will use it. The

Special Terms and Conditions provide that information. Any of the following are construed as an “Order”: “Purchase order,” “task order,” “service order,” or “job order”.

1.18. State’s eProcurement System: The State’s official electronic procurement system, established pursuant to A.A.C. R2-7-201 as set forth in the Arizona Department of

Administration State Procurement Office policy document Technical Bulletin No. 020, The

State’s eProcurement System–The Official State eProcurement System. Technical

Bulletin No. 020 is available online at:

https://spo.az.gov/sites/default/files/documents/files/TB_020_APP_20181024.pdf

1.19. State: With respect to the Contract generally, “State” means the State of Arizona and its department, agency, university, commission, or board that has executed the Contract.

With respect to administration or rights, remedies, obligations and duties under the

Contract for a given Order, “State” means each Eligible Agency or Co-Op Buyer who has issued the Order.

https://www.nist.gov/ https://spo.az.gov/sites/default/files/documents/files/TB_020_APP_20181024.pdf

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Statewide Employee Medical Exam Services

Arizona Department of

Administration

State Procurement Office

Solicitation Requirements | Revision No. 8 | Revised 03-24 | Page 26 of 68

1.20. State Indemnitees: Collectively, the State of Arizona, its departments, agencies, universities, commissions, and boards and, and their respective officers, agents, and employees.

1.21. StateRAMP: A non-profit organization that provides a uniform approach to verifying that the cybersecurity of Cloud service providers (CSPs) meets the standards and regulations needed to do business with state and local governments.

1.22. Work: The totality of the Materials and the Services and all the acts of administration, creation, production, and performance necessary to fulfill and incidental to fulfilling all of

Contractor's obligations and duties under the Contract in conformance with the Contract and applicable laws.

2. Contract Interpretations

2.1. Usage. Where the Contract:

2.1.1. assigns obligations to Contractor, any reference to “Contractor” is to be construed to be a reference to the Contractor and all Subcontractors, whether they are first-tier Subcontractors,…