DRAFT Occupational and Medical Consultant SOW 11-20-2023.pdf

FEDERAL AVIATION ADMINISTRATION

CIVIL AREOSPACE MEDICAL INSTITUTE

OCCUPATIONAL AND AVIATION MEDICAL CONSULTING

FOR

AAM-003 OFFICE OF THE DIRECTOR

STATEMENT OF WORK

December 20, 2023 i

TABLE OF CONTENTS

1.0 INTRODUCTION

2.0 SCOPE

3.0 REQUIREMENTS

3.1 MEDICAL EXAM APPOINTMENTS

3.2 AVAILABILITY

3.3 PROVIDER REQUIREMENTS

3.4 PROFICIENCY IN THE ENGLISH LANGUAGE

3.5 BASIC COMPUTER SKILLS

3.6 OTHER DIRECT COSTS

3.6.1 Facilities

3.6.2 Travel ............................................................................................ Error! Bookmark not defined.

3.6.3 Government Furnished Property

3.6.4 Obtaining Replacement of Government-Furnished Equipment

3.6.5 Electronic Communications

3.6.6 Security

3.6.7 Miscellaneous

3.7 PROGRAM MANAGEMENT

3.8 NORMAL WORKING HOURS

3.9 OVER AND ABOVE

ADDITIONAL MEDICAL CONSULTATIONS AND/OR AME EVALUATIONS MAY BE NECESSARY ON AN AS NEEDED BASIS.

REQUESTS WILL BE COORDINATED WITH THE CONTRACTOR AND APPROVED BY THE COR

4.0 ACRONYMS

1.0 Introduction

The Federal Aviation Administration (FAA) Civil Aerospace Medical Institute (CAMI) has a requirement to provide and maintain Occupational Health and Aviation Medical Examination services to FAA and other employees at the Mike Monroney Aeronautical Center (MMAC) in Oklahoma City, Oklahoma. To accomplish this mission, it is necessary to have uninterrupted service to our customers.

This effort requires a Support Services Contractor to provide professional Occupational Health and Aviation Medical Examinations for CAMI.

2.0 Scope

The contractor must provide requested Occupational Health and Aviation Medical Examinations services and tasks for any of the available services in accordance with the CAMI Clinic Scope of Practice listed below:

• Perform Pre-Placement and Return to Duty evaluations as requested.

• Order laboratory or medical prescriptions as required.

• Review Physician Assistant’s charts for consultation purposes as requested

• Perform Aviation Medical Examiner (AME) duties in accordance with the Guide for

Aviation Medical Examiners | Federal Aviation Administration (faa.gov):

• Examine applicants for, and holders of, airman medical certificates to determine whether or not they meet the medical standards for the issuance of an airman medical certificate.

• Issue, defer, or deny airman medical certificates to applicants or holders of such certificates based upon whether or not they meet the applicable medical standards.

The medical standards are found in Title 14 of the Code of Federal Regulations, part 67.

• Provide reasonable oversight and protection of any FAA resources made available for use and replace any FAA-provided resources in the event that they are damaged during use.

• Perform Occupational Medical Surveillance evaluations, i.e. Spirometry or Audiogram consultation as necessary

• Provide case consultation as needed with Physician Assistant.

3.0 Requirements

The contractor must provide the CAMI Occupational Health Clinic with Occupational Health and Aviation Medical Examiner expertise, , and perform consultations necessary for CAMI Clinic Physician Assistant(s) and Registered Nurse(s) to perform all the activities successfully as required in accordance with this SOW.

3.1 Medical Exam Appointments

A. Establishing Appointment

a. The contractor shall name an account manager or other person as the singular point of contact for all matters related to the execution of this contract.

b. Designated CAMI Contracting Officer Representative (COR) shall provide the account manager with the number of exams, type of exam required, and reason for exam request.

https://www.faa.gov/ame_guide https://www.faa.gov/ame_guide

c. CAMI will be responsible for establishing a medical exam appointment for each individual employee.

d. The contractor shall provide e-mail confirmation to the CAMI COR and the CAMI Clinic of the time and date of the examination. All appointments shall be scheduled and completed within 30 calendar days of request.

e. All billing for medical services shall be done within 10 calendar days of the last day of the previous month.

B. Determination of Medical Exam Scope.

a. Upon arrival at the medical exam location, the CAMI Clinic employee shall present the following forms as they apply to the employee’s examination: Physical, AME, Medical History, Audiogram, Noise Questionnaire, Pre-Placement Packet, Heavy Metal Questionnaire, etc.

• Forms documenting the physical used by the servicing provider may be used, provided they contain the same level of documentation. All contractor forms must be approved by COR prior to use.

b. If necessary, the contractor shall seek additional medical history, exposure history, and occupational history information from the employee.

c. The contractor shall refer to the regulations listed above to determine whether the employee is subject to specific medical examination requirements under any or all of those regulations.

d. Upon review of all pertinent documentation, the contractor shall determine and deliver a regimen of appropriate tests and examination procedures.

C. Analysis and Interpretation.

All Occupational Health examination results and lab data shall be delivered by the contractor to a board-certified Physician Assistant for review and determination of fitness. Certified AMEs are authorized to provide medical certification as outlined in the Guide for Aviation Medical Examiners and as described in Section 2.0.

D. Reports of Findings and Recommendations.

a. The contract physician shall deliver their laboratory and examination findings and recommendations to:

1. The employee examined.

2. The CAMI Clinic via fax or in person.

b. If the employee is found fit for clearance, the occupational health physician/AME shall issue a memorandum of medical clearance/medical certificate via secure email to the employee and the CAMI Clinic within 7 business days (or 1 working week) of completion of appointment.

c. If the employee is found unfit, the occupational health physician shall counsel the employee regarding the findings and any recommended follow-up actions.

E. Record Retention and Storage

a. The contractor shall retain and store all medical documentation in accordance with the Privacy Act of 1974 and OPM/GOVT-10 Employee Medical File System Records.

b. In the event of contract termination or business interruption, the contractor shall ensure the secure transfer of all records in its care to an entity designated by the CAMI COR.

F. Invoicing of Fees for Service The contractor shall submit an invoice of fees for service for all performed activities including, but not limited to the following:

• Pre-Placement Exam

• Return to Duty Exam

• Aviation Medical Examiner (AME) Exam

• Physician Assistant’s Consultation

• Occupational Medical Surveillance evaluations/consultation, i.e. Spirometry or

Audiogram

• Record Processing/Administrative Fees

The invoice must be submitted in accordance with the contract and be itemized per exam on an hourly basis. All services must be performed in accordance with the current requirements for each evaluation. Contract physician is expected to verify the government requirements before performing the service to ensure completeness.

3.2 Availability

At minimum, the contractor must be available two (2) days a week to perform Occupational Health Medical Support and AME Flight Physicals at the CAMI Clinic located at MMAC, Oklahoma City, in person, for at least 4 hours per day during periods of time when an FAA Physician is not available. Additional support will be negotiated on an as needed basis and can be virtual as applicable.

3.3 Provider Requirements

Healthcare providers in the CAMI clinic will meet the following requirements:

• Must currently carry state licensure within the United States as a Physician (Doctor of Medicine/M.D. or Doctor of Osteopathic Medicine/D.O.)

• Must remain current with state licensure in any state.

• Must provide a replacement when unavailable to perform duties under scope of practice.

• Must have previously completed or will complete within six months of contract award the Basic Aviation Medical Examiner Seminar held in Oklahoma City, Oklahoma.

• Must be board certified in Occupational Medicine.

• Must be certified in Basic Life Support (BLS) and Advanced Cardiovascular Life

Support (ACLS).

• Must be certified as Council for Accreditation in Occupational Hearing Conservation

(CAOHC) Professional Supervisor.

• Must hold Medical Malpractice Insurance.

• National Institute for Occupational Safety & Health (NIOSH) Spirometry Certification preferred.

3.4 Proficiency in the English Language

The contractor must be capable of providing an acceptable and comprehensibly written document addressing the medical issues relative to the disability program that have arisen as a result of the contractor’s case reviews. Proficiency in English is required.

3.5 Basic Computer Skills

Contractors shall be able to perform basic tasks with a computer, including, but not limited to sending and receiving emails, conducting research, interacting with others via the internet, creating and editing documents, spreadsheets, etc. Objectives and description of skills to be demonstrated include but are not limited to:

1. Knowledge of basic computing concepts.

2. The ability to perform fundamental operating system functions:

a) Identify different operating systems for personal computers

b) Utilize the user interface

c) Manipulate windows: resize, move, close, and scroll

d) Manage files -

i. Manipulate folders: create, delete, rename

ii. Manipulate files: create, delete, rename, sort

iii. Understand what directory and file specification paths are

iv. Understand file formats

3. The ability to use computers in a secure manner:

a) Know how to check for different types of Internet hoaxes, such as viruses, or phishing

b) Able to manage multiple passwords across various systems.

4. The ability to use common software applications, such as:

a) Word processing – create, save, retrieve text, file

b) Spreadsheet program – create, manage, and manipulate numeric data

c) Presentation software – create presentations

d) Zoom – instant messaging and meeting software

e) Microsoft Teams – instant messaging and meeting software

5. The ability to use the computer for internet access and electronic communication.

Specifically, the ability to:

a) Use the internet – navigate websites

b) Handle email – read/reply, create signatures, delete and manage; send and open email attachments

c) Conduct internet and database searches to obtain information and resources

6. The ability to adapt to changes in existing or new FAA systems:

a) Use various computer hardware items.

b) Utilize current EMRS (Electronic Medical Record System)

3.6 Sensitive Unclassified Information (SUI)

A. The Contractor must:

1. Safeguard FAA Airman/ATC Medical Records

2. Not access FAA medical records unless they have reason to do so.

3. Not discuss FAA Airman/ATC Medical Records with anyone who does not have a need to know.

B. The Contractor must provide and maintain a signed Non-Disclosure Agreement in order to work with FAA Medical Records.

C. The Contractor will handle SUI in accordance with FAA Order 1370.121A: FAA Information Security and Privacy Program & Policy and the Privacy Act.

D. The Contractor will have established procedures for securing materials and data (re: NIST Special Publication 800-171, Protecting Controlled Unclassified information in non-federal information systems and organization) upon contract award that will include:

1. Procedures for reviewing all documents for SUI to include Personally Identifiable

Information (PII)

2. Procedures for safeguarding "Confidential" and "Sensitive" materials

3. Procedures for assurance that all documents are secured at all times and are never left unattended including safeguard measures for Protected Health Information (PHI)/Health Insurance Portability and Accountability (HIPAA) data.

4. Procedures to prevent discussion outside of information contained on any medical or other document containing personally identifiable information (PII)

5. Procedures to prevent addresses or information from being disseminated to anyone regarding a specific individual, e.g., celebrities or dignitaries

3.7 Other Direct Costs

3.7.1 Facilities

The Contractor must maintain an office within a 50-mile radius of the location of the MMAC for the use of their personnel providing services under the contract. The facility must include usage of a telephone for teleconferencing, e-mail, and availability of photocopying and normal support equipment and services.

The services required hereunder must be performed at the CAMI Clinic location unless contractor office use is authorized by the FAA. The contractor must be able to operate at the CAMI Clinic no later than 10 days after contract award. While on site, a workspace and all necessary medical equipment will be provided for the contractor as Government Furnished Equipment (GFE).

3.7.2 Miscellaneous

The contractor may incur cost for incidental nonrecurring items such printing, special supplies, etc., with the prior approval of the COR.

3.8 FAA General Requirements

3.8.1 Government Furnished Property

The Government will provide, without cost, adequate and necessary working space, office furniture, equipment, supplies, and materials required to successfully accomplish the requirements outlined in the PWS for Contractors working on the MMAC campus. All operating expenses, maintenance, and repairs of Government provided property will be furnished by the Government. The government will assume no liability or responsibility for the Contractor. The Contractor shall not alter property in any way to include the Code of Federal Regulations (CFR) Part 67, AAM-300 Quality Management System (QMS), Guide for Aviation Medical Examiners (AMEs), Aeromedical Reference Manual “RefMan”, and other pertinent documentation.

The Contractor must return property to the Government in the same condition as received, with reasonable wear and tear. The Contractor must reimburse the Government for repairs resulting from negligence of the contract employees. The property must only be used in the performance of this contract. The Government will provide to the Contractor working on the MMAC campus, without cost.

The Government will provide, without cost, a computer (laptop) to the Contractor working in person and remotely.

3.8.2 Obtaining Replacement of Government-Furnished Equipment

The Contractor must submit requests for replacement of Government-Furnished Equipment to the COR for processing. Such requests must specify the reason for the replacement request.

3.8.3 Electronic Communications

The Contractor must assure an electronic means for communicating with FAA personnel. The Contractor must ensure that the communications are compatible with the FAA's electronic mail system that is currently Microsoft Outlook. The Contractor must also ensure that the Contractor's electronic mail has the capability to receive and retrieve attachments.

3.8.4 Security

The contractor shall observe and comply with all FAA/CAMI policies, regulations and procedures concerning COVID-19, fire, safety, environmental protection, sanitation, identification, security, traffic, parking, limited access areas, gratuities, and conduct. Contractors working in government facilities shall be responsible for compliance with applicable building and physical security requirements. These requirements include, but are not limited to, the use of authorized entrance and exit points, responsibility for securing doors, protecting government property from loss theft abuse or damage, and the use of telephones and computers for only mission related activities. The contractor shall be responsible for safeguarding all Government property issued for contractor use. The Contract personnel are required to perform services in secure facilities. Entrance into working spaces at MMAC requires Government issued key card. The Contractor employees may not begin work until forms are submitted and have been reviewed and authorized by the FAA’s Office of Personnel Security (AXP).

3.8.5 Clearances

All Contractor personnel are required to submit to a FAA Background Investigation (BI).

Contractor personnel are required to complete the security forms and forward them to the Investigations Division, prior to assignment to work location and performing work.

Contractor employees may not perform work under this task, or any subsequent sub-tasks, until they submit the security forms and FAA gives preliminary approval for assignment.

Should the FAA determine that a Contractor employee is unsuitable for a position, the Contractor employee will be denied access to FAA facilities, sensitive information, and will not be eligible for assignment to this task.

3.8.6 Badges

The Contractor shall be responsible for transitioning employees if required and obtaining an FAA issued visitor’s badge and car parking pass for each employee upon initial entry to the work site.

While on FAA premises, each Contractor shall wear their FAA visitor’s badge at all times in accordance with FAA/MMAC current policies and directives.

3.9 General Conduct

While the contract physician is at the Government site, they must comply with all rules and regulations in effect at that site. Contractors must comply with rules and regulations governing employee conduct with respect to health and safety, not only as they relate to themselves, but also to other Government employees or agents of the Government.

3.10 Program Management

The contractor must efficiently and effectively manage the performance under this contract to ensure all the necessary technical, business, and administrative planning; organizing; managing;

coordinating; and tracking (e.g., cost, schedule, deliverables), performance management, risk management, component procurement management, system engineering management, resource management, data management, and subcontract management required to perform all the activities successfully as required in the SOW.

The Contractor must ensure that assignments are completed in a thorough and timely manner and prepare written documentation of accomplishments. The FAA requirements in performing this contract demand that the Contractor's medical and administrative support and the level of expertise, experience, and demonstrated performance of contractor personnel providing the services must be at the highest level of providing quality support.

The Contractor must provide sufficient personnel, both in number and qualification to perform work described herein.

The Contractor must provide sufficient oversight and supervision of the contract in order to ensure all employees are functioning within their designated labor categories and at acceptable levels of performance and are performing their designated assignments in a timely manner and that all reporting requirements are honored.

Author This document addresses requirements of Contractor to include government property, security protocols, technical needs, etc. Can we address requirements to follow FAA Code of Conduct? �

Author RDC Response: Is there standard language in all contracts?

Author We do have that language for our internships and rotations, so can certainly see adding it here. -AMV

Author Did you still need a list of equipment in the clinic?

Author I believe this can be closed out.

Author Added language for conduct

Author Concur

3.11 Normal Working Hours

When working on the MMAC campus, the Contractor must perform tasks during the Government's primary operational hours, Monday through Friday, 7:30 AM through 5:00 PM. Normal clinic hours are Monday through Friday from 8:30 AM to 12:00 PM and 1:00 PM to 4:30 PM. No work shall occur on federal holidays, or any other day(s) designated by Federal Statute, Executive Order, or Presidential Proclamation.

When working remotely, the Contractor need not comply with normal working hours.

3.12 Over and Above

Additional medical consultations and/or AME evaluations may be necessary on an as needed basis. Requests will be coordinated with the contractor and approved by the COR.

4.0 Acronyms

AME Aviation Medical Examiner AMS Acquisition Management System CAMI Civil Aerospace Medical Institute CO Contracting Officer COR Contracting Officer's Representative FAA Federal Aviation Administration GFE Government Furnished Equipment MMAC Mike Monroney Aeronautical Center SOW Statement of Work

4.0 Acronyms