Draft SOW__PSCFOH-ClinicalWest-PSC347298.pdf

Federal Occupational Health (FOH) - Clinical Occupational Health Support Services – Clinical Staffing (WEST)

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SECTION C - Description/Specifications/Statement of

Work

TITLE: Federal Occupational Health (FOH) - Clinical Occupational Health Support Services –

Clinical Staffing (WEST)

Under authority legislated to FOH in 42 USC § 216, Continuing Appropriations Act, 2021, and Other

Extensions Act (Act), Pub. L. No. 116-159, div. C, title I, sec. 2107 (Oct 1, 2020), and in accordance with the Federal Acquisition Regulation (FAR), this contract is issued as a Personal Service Contract.

Federal Occupational Health (FOH) is currently funded through the HHS Services and Supply Fund

(SSF), a revolving fund appropriation, which was established pursuant to 42 USC §231 for the purpose of providing (1) supply services to HHS and other government offices and (2) such other services as the HHS Secretary determines may be performed more advantageously as central services.

FOH provides various occupational health and related health services to both HHS and other Federal agencies. FOH authority to provide such services is found in 5 USC § 7901. The intent of the Statute is to promote and maintain the physical and mental fitness of federal employees in the workforce. The employee occupational health services authorized under 5 USC §7901 are performed by FOH as centralized services through the SSF. The Continuing Appropriations Act, 2021, and Other Extensions

Act, Pub. L. No. 116-159, div. C, title I, sec. 2107 (Oct 1, 2020) states that the SSF Statute “shall be applied with respect to any fiscal year as though the phrase ‘central services’ referred to central services for any Federal agency.” This provides specific transfer authority for the provision of occupational health services under 5 U.S.C. §7901 for both HHS employees and employees of another federal agency.

Section 216 of the Department of Health and Human Services Appropriation Act, 2006 (FY06 HHS

Appropriations Act), Public L. No. 109-149, title II, 119 STAT. 2844 (Dec. 30, 2005), which is a permanent provision of law, provides FOH authority to enter into personal services contracts for the limited purpose of employing “professional management/administrative and occupational health professionals.” Many federal agencies enter into an interagency agreement (IAA) with FOH, given its expertise, to provide federal occupational health services. (FOH cannot enter into agreements which involve the acquisition of personal services for other Federal agencies.) To fulfill interagency orders for federal occupational health services which require the use of professional management/administrative and occupational health professionals, this contract is established as a personal services contract to enable HHS to provide such services to HHS and other federal agencies.

The work performed under this contract requires the Contractor to be in a uniform location, use

Government equipment, adhere to Government policies and procedures, perform inspections, accept work and execute management functions under relatively continuous supervision and control of a government officer or employee.

Offerors should refer to the Federal Tort Claims Act, Title 28, Chapter 171, and Title 28, Section 1346 information on the Federal Tort Claims Act. Agencies cannot waive the FTCA by contract.

C.1 BACKGROUND

FOH provides defined health services as well as consultation to Federal customer agencies exclusively through Interagency Agreements (IAAs). FOH is the Federal Government’s largest provider of occupational health services (OHS), supporting multiple federal agencies and serving over 1 million federal employees. FOH enters into agreements that are negotiated with federal departments and federal agencies’ national headquarters, and/or with their regional/local components for standard services, including clinical services delivery, expert medical consultation tailored to a particular federal agency’s OHS needs, wellness and health promotion, and behavioral health services. FOH maintains

Federal Occupational Health (FOH) - Clinical Occupational Health Support Services – Clinical Staffing (WEST)

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Provision Sites (SPS) by providing Personal Service Contractors (PerSCs) who will perform these services.

FOH defines OHS as the seamless coordination of comprehensive services using a data-driven approach to assist agencies in achieving a culture of health and high performance.

FOH comprehensive services include:

• Clinical Health Services (CHS) - Occupational medicine services, including medical examination, consulting, and case review services that focus on assessing the medical ability of employees to perform their essential job duties safely, reduce lost workdays, and increase employee productivity.

• Environmental Health and Safety Services (EHSS) – Services to ensure a safe working environment through site assessments, environmental health oversight of all FOH occupied spaces, emergency preparedness and emergency response.

• Wellness and Health Promotion Services (WHPS) - Services to assist employees in achieving and maintaining good health through fitness classes and wellness program.

• Behavioral Health Services (BHS) – Employee assistance program, Work/Life and other services designed to promote emotional well-being and a healthy life balance through stress management, financial and legal counseling, and professional referral.

These services are designed to improve health outcomes and employee productivity, while reducing occupational health risks, absenteeism and overall employee healthcare costs. FOH’s vision is to be the occupational health provider of choice for the federal government.

FOH CHS staff play a critical role in ensuring FOH maintains its status as the premier provider of integrated OHS to federal agencies and their employees. By offering flexible, cost competitive solutions, FOH CHS sets the standard for a culture of health and safety across the federal workforce.

The Contractor is required to provide PerSC support for all occupational health services that FOH provides, including health promotion activities, data collection, and Agency/FOH initiatives requiring collaboration.

PerSCs are responsible for providing quality and safe health care, health education, and for raising

FOH client awareness of health indicators, associated risks to optimal health, and viable solutions for maintaining optimal health.

CHS achieves these goals through services, including, but not limited to:

• Occupational health examinations – pre-placement, clearance, surveillance, federal motor carrier, and other types of occupational health exams.

• Immunizations

• Preventive and routine health screenings

• Health risk appraisals

• Occupational health case review programs

• Travel medicine assessments

• Occupational exposure testing and surveillance programs

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• Health education programs

• Workplace medical emergency response

• Specialized health services, as requested and approved

• Consulting

The quality of clinical services and strength of program effectiveness depend heavily on the expertise and experience of the PerSCs who provide direct patient care, occupational health services, and education.

PerSCs will be expected to provide quality services both in individualized and group settings, placing client/patient needs at the forefront of service delivery. All PerSCs will be required to possess and maintain appropriate credentials, licensure, and certifications to provide the specific services called to perform.

PerSCs participation in professional associations and specialized training are strongly encouraged to keep current with identified best practices and medical advancements. Contractor promotion of such participation and pursuits is expected.

SPSs include FOH Occupational Health Centers, FOH Area Offices, and remote sites throughout the contract area. Services provided under this contract shall primarily be performed at the SPSs in accordance with Site Staffing Plan (Attachment J.2).

C.2 SCOPE

The Contractor shall furnish all the necessary personnel, office supplies, materials, services, facilities, (except as otherwise specified), and otherwise do all the things necessary for or incident to the performance of the work as set forth in each task order.

FOH SPSs are grouped together in three regions: Western Region (WEST), Eastern Region (EAST) and the National Capital Region (NCR). The Contractor shall provide PerSCs to the region in which the Contractor has been awarded a contract/task order. At any point during the life of the contract, the

Contractor may be issued a task order to provide PerSCs to another SPS(s) in a different region should

FOH request it.

Work performed under this contract will occur at multiple FOH SPSs in the FOH Clinical Western

Region (WEST) including but not limited to:

Alaska, Arizona, California, Colorado, Hawaii, Idaho, New Mexico, Montana, Nevada, Oregon, Utah and Washington.

The Contractor shall provide PerSCs who are capable of performing general and to a lesser extent complex occupational health services such as: various occupational health medical examinations;

response to emergencies; first aid and treatment for minor illnesses and injuries; provision of health education and health counseling based on identified modifiable health risks using FOH-approved training materials, policies and protocols; and other services including but not limited to the following:

a. Walk-in care, first aid, and emergency response including use of portable Automated External

Defibrillators: (AEDs).

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b. FOH-approved provision of treatments prescribed by a personal physician such as: periodic bed rest, blood pressure monitoring; glucose monitoring (finger stick); allergy immunotherapy, other treatments and medications administered by injection.

c. Provision of short-term prescriptions by appropriately FOH privileged Licensed Independent

Practitioner (LIP) as needed.

d. Health education, health coaching, and training programs using FOH training materials, policies and protocols (e.g. Physical Activity, Weight, Stress Reduction, Nutrition, Bloodborne Pathogens, Respirator Fit Testing, etc.).

e. Health screenings (e.g. cancer, diabetes, blood pressure, vision);

f. Annual Wellness Assessment to include, but not limited to individualized health education and health counseling; health risk reduction seminars focused on core health risks (e.g., tobacco use, physical inactivity, and weight/BMI); and referrals.

g. Occupational medicine examinations, including pre-placement, clearance, surveillance, fitness for duty, and return to work physical examinations as well as standard and specialized (occupational health exposure) lab analysis, as needed.

h. Travel examinations and evaluations, including counseling about recommended travel medication and preventive health measures.

i. Administration of immunizations (e.g. Hepatitis A, Hepatitis B, TDAP/TD, Typhoid, Yellow Fever, etc.).

j. Testing related to medical surveillance and/or specific job requirements (e.g., audiometry, spirometry, electrocardiogram (EKG), vision testing).

k. Complete required trainings, such as leading and conducting mock surveys, preparing service provision sites to meet the FOH designated national health care quality organization survey standards, and comply with all FOH policies and procedures.

l. Participate in FOH initiated performance improvement and risk management activities.

m. Provide outreach services (health promotion activities such as health screenings, immunizations which may include flu vaccines, health education activities) in locations outside the SPS.

C.3 DEFINITIONS

Day - Day means a business day, unless otherwise specified.

Emergency Response/First Aid - First aid includes walk-in care and treatment for minor injuries (e.g.

minor burns, cuts, bruises, sprains) and illnesses (e.g. colds, headaches). Emergency response includes administering Basic Life Support (BLS) with use of automated external defibrillators, as well as coordination with local emergency medical services (EMS) providers as necessary.

Security Clearance - A personal vetting process used by the federal government to determine whether an individual is trusted to access confidential information in their work on behalf of the government, occupy a sensitive position, or be granted access to government IT systems and/or facilities.

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Federal Occupational Health (FOH) - A service component within the Department of Health and

Human Services offering a comprehensive occupational health programs to improve the health, safety and productivity of the federal workforce. FOH’s governing organization is the Program Support

Center (PSC), within the Office of the Assistant Secretary of Administration.

FedStrive National - The defined scope of services that are packaged into an FOH health maintenance and wellness services program. This service supplements routine walk-in care and appropriate referred services and is billed to FOH customer agencies at a per capita rate.

Fee for Service - A service billing strategy in which specific occupational health and wellness services are provided to customer agencies for defined fees (costs) billed at the time when services are performed. Services offered are unique to the customer agency that negotiates for the specified services.

FOH Customer - A federal agency who has entered into an inter-agency agreement with FOH to have their federal employees utilize an SPS.

FOH Leadership Team - Comprises senior leaders within FOH and is responsible for organizational management and planning; approval of FOH’s scope of services; approval of the annual operating budget, monitoring contracted services; providing the resources needed to maintain safe and quality care, treatment and services; annual evaluation of FOH’s performance in relation to mission, vision, and goals; ongoing performance improvement; maintaining a Culture of Safety; reviewing and approving policies and procedures; evaluating equipment, supplies and other resources to support the

FOH mission; and oversight of all FOH working committees.

Hours – Ad-Hoc – Hours required for outreach, schedule fee-for-service, exams, and/or to fulfill a specific FOH customer service request.

Hours – Steady-state - Hours required for each OHC to be open and/or to fulfill a specific FOH customer agreement

Job Specific Position Description (JSPD) - Written position descriptions specific to each individual labor category that define the qualifications, responsibilities, tasks, as well as staff education, training, and experience requirements specific to a particular position and scope of service.

Job Sharing - Using two (2) PerSCs to cover a single steady-state position on the Site Staffing Plan with FOH leadership approval.

Labor Categories: Specific work types with defined qualifications, experience, and responsibilities for a contractor or contractor employee who performs work on this contract. For example, Area

Clinical Managers (ACMs), Physicians, Physician Assistants (PAs), Nurse Practitioners (NPs), Nurse

Coordinators (NCs), Staff Nurses (SNs), and other professionals on this contract. (See Attachment J.3 for complete list of labor categories along with specific requirements.)”

Licensed Independent Practitioner (LIP) - Any individual permitted by law (i.e., the statute which defines the terms and conditions of the practitioner’s practice in the state of licensure) to provide client services independently, i.e., without supervision or direction, within the scope of the individual’s license, and in accordance with individually granted clinical privileges.

New Hire - A PerSC that the Contractor has recommended to FOH and has all security clearance paperwork submitted to FOH for a specific position(s) to fill a vacancy or new position.

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Personal Service Contractors (PerSC) - Contractor employed personnel (staff) with precise qualifications dictated by FOH to fulfill contract staffing needs and provide direct clinical services to customer agency employees.

Pro Re Nata (PRN) - Relief/substitute PerSCs used when permanent PerSCs are not able to provide services. PRNs are fully trained, and competency tested at the same level as a permanent PerSC who would normally be staffing the position.

Service Provision Site (SPS) - A location where FOH health services are rendered. SPSs include FOH

Occupational Health Centers (OHC), FOH Area Offices, and remote sites throughout the contract area.

Work Order - A work request for health and wellness services for an agency/group of federal employees. The work order includes a checklist of approved services based on agency requirements, as determined by the interagency agreement that may include scheduling of the work. The work order can be used when requesting identical services for individual federal government employees or for groups of authorized federal government employees.

Work Plan – The work plan details the site locations, labor categories, labor hours and labor rates.

C.4 CURRENT CHALLENGES

The Contractor can expect to face several major challenges throughout the life of this contract. These challenges if not properly managed and controlled by the Contractor will result in the Contractor not providing the services required in this SOW and may jeopardize FOH’s mission and the mission of

FOH’s customers.

Key challenges specific to this contract the Contractor shall be aware of and shall properly manage, and control are:

• Maintaining a properly oriented/trained/security cleared staff

• Maintaining readily available PRN pool to meet fluctuating workload demands

• Staffing of vacant positions

• Timely, accurate and complete submission of security clearance paperwork

• Timely, accurate and complete submission of LIP credentials and requests for privileges

C.5 REQUIREMENTS (OCCUPATIONAL HEALTH STANDARDS)

FOH continues to use the Ambulatory Care (AC) Standards through The Joint Commission in Health

Care Staffing Services (TJC-HCSS) occupational health standards as its benchmark for quality and safety. TJC is an independent, not-for-profit organization which accredits and certifies more than 20,000 health care organizations and programs in the United States. TJC-AC accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting specified performance standards. FOH has invested significant time, energy, and resources into transforming its policies, procedures and business operations to stay aligned with TJC standards. FOH’s compliance with TJC standards further aligns FOH’s business-operation and efficiency goals with industry-leading quality and safety measures, and positions FOH for continued growth to consistently deliver high-quality services in an increasingly competitive market.

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C.6 REQUIREMENTS (FOH POLICY)

The quality of services provided by the Contractor and its PerSCs shall be guided by national standards. These standards include, but are not limited to: TJC standards http://jointcommission.org; the American Medical Association (AMA) standards http://www.ama-assn.org; the American Association of Occupational Health Nurses (AAOHN) standards http://www.aaohn.org; the American College of Occupational and Environmental Medicine (ACOEM) standards http://www.acoem.org, other standards recognized by relevant national medical specialty boards, established principles and ethics of related professions; and the standards of care in the state or locality where the services are provided.

FOH maintains a robust Quality, Safety, and Risk Management (QSRM) program. To provide and maintain a safe, functional, supportive, and effective environment for clients and staff in the healthcare and health and wellness setting, FOH requires all PerSCs to adhere to the components outlined in the

FOH Safety Plan, FOH Performance Improvement Plan, and associated policy and procedures. This includes PerSCs proactively supporting a culture of quality and safety by participating in safety event reporting, data collection, tracking, and analysis, along with staff surveys to inform performance improvement activities. FOH contract staff engagement, including participation on FOH committees and interdisciplinary teams, is an integral component of client and staff safety programs.

C.6.1 FOH Health Center Policy

The Contractor shall provide all services in accordance with FOH Policies, Standard Operating

Procedures (SOP), Local Operating Procedures (LOP), Agency Specific Procedure (ASP), special directives and “ALERTS” as specified in FOH Policies with guidelines provided by the Contracting

Officer’s Representative (COR). The COR will inform the Contractor in writing when any updates are made to FOH policies, SOPs, LOPs, ASPs, special directives and “ALERTS” that will, or may, impact/modify the performance of operations and clinical activities. The Contractor shall implement all new changes upon notification. Critical clinical alerts and associated service delivery and management responses will be communicated directly to PerSCs via government email accounts and will be available on the FOH intranet (FOH Staff Portal) for twenty-four hour (24-hour) online access when they are issued.

C.6.2 COMMUNICATION POLICY

The Government will provide all applicable PerSCs with an FOH/HHS/United States (US) Government managed email account that will represent the official channel of communication by which PerSCs will receive critical operations instructions delivered by FOH. PerSCs will be required to access their email account within one (1) business hour at the beginning of every work shift and every two (2) business hours throughout the workday. In those special cases where an FOH email account may not be accessed within the SPS (usually due to elevated security measures imposed by the customer agency), PerSCs will be assigned an alternative method of receiving critical operations communications that will be used to deliver directives.

The Contractor shall notify the COR and/or their designee within two (2) business hours if a SPS’s designated communication method becomes unavailable or is otherwise hindered. The Contractor shall assist in ensuring the PerSC has appropriately obtained FOH email access. It is the responsibility of the

PerSC to maintain FOH email and ensure the account remains active. If the PerSC is not scheduled within a 30-day period, the Contractor shall provide appropriate notification to the COR so that appropriate measures can be taken to maintain email account. For the Licensed Independent

Practitioners who may have limited IT access - PerSCs will check email at least once each workday.

PerSC may receive critical information and instruction directly from FOH and may receive http://jointcommission.org/ http://www.aaohn.org/ http://www.acoem.org/

Federal Occupational Health (FOH) - Clinical Occupational Health Support Services – Clinical Staffing (WEST)

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LIP. FOH may send information, alerts or other instruction to the Contractor for dissemination to the contract staff. The Contractor shall ensure all intended contract staff receive and acknowledge receipt of the information provided by the FOH specified deadline.

The contractor shall notify the COR immediately upon notification of a complaint received concerning a service delivery site(s) and/or provider(s). The contractor shall notify the COR of the resolution of a complaint concerning a service delivery site(s) and/or provider(s) within seven (7) calendar days of receipt of complaint.

C.7 CUSTOMER SATISFACTION

FOH utilizes a Customer Satisfaction (Cx) survey for compliance with occupational health standards.

The Cx survey is intended to measure the satisfaction of FOH’s service delivery and improve our processes. The Contractor may have the opportunity to collaborate with FOH in the development of new Cx surveys.

C.8 REQUIREMENTS (PERSONNEL)

The Contractor shall recruit, hire and retain qualified and competent PerSCs. PerSCs include but are not limited to: Area Clinical Managers (ACMs), Physicians, Physician Assistants (PAs), Nurse

Practitioners (NPs), Nurse Coordinators (NCs), Staff Nurses (SNs), and other professionals as necessary. (See Attachment J.3 for complete list of labor categories along with specific requirements).

For certain labor categories, access to, physical entry into, and mobility within a federal facility may not be required - In those instances, the contractor will communicate this to the CO and/or COR for instruction.

C.9 PROPOSED CANDIDATES

In collaboration with FOH, the Contractor shall provide fully screened, qualified, candidates that meet educational, training, competency, licensure, experience, and appropriate health status to perform the physical requirements of the position to be hired for, as well as the ability to obtain and maintain the level of security clearance identified by the COR for a position. FOH may also perform an interview of potential candidates. The Contractor shall provide PerSCs that have direct, verifiable experience in occupational health, public health, acute care settings such as primary care, urgent care emergency department, or primary adult ambulatory care services. PerSCs shall have current state license(s) and/or certifications to practice in their respective professional fields. PerSCs with pending actions against their state license shall not be considered for hire under this contract. PerSCs with past actions against any state license will be considered only if no loss of licensure or privileges resulted from the action. PerSCs with adverse actions against their past or current privileges will be considered on a case-by-case basis. PerSC LIPs shall have and maintain a current hands-on Basic Life Support -

Health Care Provider (BLS-HP) certification. PerSC nurses shall have and maintain a current BLS-HP certification. Contractor shall track and maintain PerSC state license, BLS-HP certification, and other required certification, and provide a monthly report at time of draft invoice submission to the COR.

FOH retains the right to determine the adequacy of a Contractor’s proposed PerSC to meet evolving

FOH customer needs throughout the life of this contract. FOH has the authority to disapprove of any proposed PerSC based on qualifications, experience, peer references, and/or performance.

Upon COR notification of needing a new position, the Contractor shall provide to the COR within

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Other documents required are:

• Curriculum Vitae with a comprehensive list of all current and past State licenses held.

• Copy of all current active licenses

• Copy of Basic Life Support - Health Care Provider (BLS-HP) certification card

• State license, verified

• Verification of board-certification or board-eligibility for LIPs

• Peer references (three completed on FOH form)

• Current privileges if applicable

• Additional documents as required

Occupational Health Provider PerSCs must have CPR Certification and Automated External

Defibrillator (AED) training. All licenses, registrations and certifications shall be renewed and maintained in a current status during the life of the contract. On-line CPR certification or AED training is not acceptable. Training must be completed from either the American Heart Association, American

Red Cross, or American Safety and Health Institute. While PerSCs are not required to have a license for the specific state or District in which they are providing services under this contract, they shall continue to follow the requirements of State Practice Acts and prevailing local standards of care.

C.10 JOB SPECIFIC POSITION DESCRIPTION (JSPD)

The Government will develop the JSPD and provide it to the Contractor within two (2) calendar days of PerSC start date. The JSPD will consist of two parts:

1) the Contract Labor Category description and,

2) the list of duties and responsibilities of the position the employee occupies. The JSPD shall be signed by both the Contractor and the PerSC and provided back to the COR prior to the PerSC start date. JSPDs will be updated on an annual basis, or as directed by the COR if the position changes and shall be re-signed by both the Contractor and the PerSC. The PerSC shall be provided with a copy of the signed JSPD.

C.11 FITNESS FOR DUTY/HEALTH REQUIREMENT

The Contractor shall provide PerSCs who are capable to perform the physical requirements of the duties described in this SOW and the JSPD (e.g. CPR performance, responding immediately to an emergency, carrying a thirty (30) pound Emergency Go-Bag, etc.) without accommodation as well as free from any communicable disease(s). The Contractor shall ensure that each PerSC completes an annual self- declaration of health status (aggregate reporting only). The self-declaration shall be maintained as part of each PerSC’s credentialing file that is retained with the vendor. FOH reserves the right to remove from the contract any PerSC found incapable of performing their duties and/or unable to perform the physical requirements of the position.

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The Contractor shall provide to the COR a PerSC’s self-declaration of health form before the PerSC is able to return from an illness, communicable disease or an injury which prevented the PerSC from performing their duties as described in their JSPD. FOH reserves the right to question a PerSC’s fitness for duty and the Contractor shall provide documentation of fitness for duty within two (2) business days of a request.

C.12 COMPUTER AND ELECTRONIC HEALTH RECORD LITERACY

The Contractor shall ensure that all PerSCs have general computer literacy (e.g., email, Internet, and

Microsoft applications), knowledge/ability to use a Government provided Electronic Health Record

(EHR) system or other service utilization tracking technology and familiarity with medical coding schemas and their applications to an EHR system for their tasks specifications. If during the contract, FOH determines that a PerSC does not have sufficient computer skills to efficiently perform the required tasks, the Contractor shall provide appropriate training to the PerSC within 30-days to elevate the PerSC’s skills to a sufficient level as determined by FOH. The Contractor will be required to replace any PerSC who is unable to demonstrate competency within sixty (60) days as determined by

FOH. The Contractor shall bear the burden of any training costs associated with the training.

C.13 OCCUPATIONAL HEALTH CARE DELIVERY EXPECTATIONS

The Contractor shall ensure that all PerSCs who provide direct care services or manage/supervise those who provide direct care services have a working knowledge of the designated national health care quality organization standards (current TJC-AC standards) as well as follow FOH policies and procedures when providing services to FOH clients. FOH policies and procedures are updated frequently to meet industry standards, best practices, and designated national health care quality accreditation standards and the PerSCs must remain current with the changes and updates.

The Contractor shall ensure that all PerSCs, including physicians, physician assistants, nurse practitioners, and registered nurses shall possess skills in interviewing and assessment of patients, general management and customer service skills (as they pertain to FOH).

C.14 PROFESSIONAL ATTIRE AND APPEARANCE

The PerSCs shall wear professional attire and always maintain a professional appearance while providing services under this contract. General requirements include: All identification badges must always be displayed above the waist level. Closed-toe shoes and socks/stockings shall cover the foot to meet sanitation and safety requirements – no open toe shoes/sandals shall be worn. All PerSCs must wear dresses, skirts, pants, or slacks with shirts or blouses tucked in neatly with a professional appearance, shoes and socks. Tank-top shirts, cut-off jeans, shower shoes or similar items of apparel are specifically prohibited. Health care workers shall not wear artificial nails and shall keep their natural nail tips less than, or equal to, 1/4 inch long. The wearing of medical scrubs may be decided as the duty uniform and must be solid in color. FOH-provided disposable cover gowns shall be worn in situations where occupational exposure to potentially contaminated blood and/or body fluids exists.

The wearing and disposal of these gowns shall be in accordance with OSHA standards.

C.15 LAB COATS

Lab coats shall be worn by all direct service staff during normal duty hours. The lab coats will be white in color, with no logos and no longer than knee length. The lab coats must be clean and professional in appearance and free of stains, tears, and signs of disrepair. The purchase and laundry of the lab coats is the responsibility of the Contractor.

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C.16 IDENTIFICATION BADGES

The Contractor shall procure and provide compliant staff identification badges to all PerSCs. The badge shall be black with white lettering or white with black lettering, showing the PerSC’s full name, license credentials (i.e., MD, PA, RN, NP, etc.), and other pertinent information as determined by

FOH policy. The badge shall not bear the name of the Contractor or agency being served. FOH must approve all Contractor provided badges prior to use.

Example:

John J. Jones, MD, PA, RN, etc. Federal Occupational Health

C.17 FOREIGN NATIONAL PerSCs

When presenting foreign nationals as candidates for employment, the Contractor shall provide proof of citizenship, evidence of legal admission to the United States, and evidence of unrestricted authority for employment in the United States. This information shall be submitted along with the credentials of the proposed foreign national candidate. For foreign national physician candidates, the Contractor shall obtain and keep on file all documents as required in FOH credentialing policies and SOPs.

C.18 REQUIRED KEY PERSONNEL

The Contractor shall provide a list of names, organizational structure, and contact information for all individuals who are considered essential to service provision and are supervising or leading personnel on this contract within ten (10) business days of contract award. Listing shall include but is not limited to any proposed non-billable personnel (e.g., Contractor’s POC) and direct billable labor categories

(i.e., Area Clinic Managers) proposed by the Contractor as essential. The organizational structure shall identify a single POC for the contract the COR will be able to direct questions and concerns, or POCs for specific portions of the contract (e.g., scheduling or badging). Any updates and/or changes shall be provided to the COR within three (3) business days of an effective change prior to contract award.

For direct billable labor categories, the Contractor shall submit to the COR the name and resume of the

POC for approval prior to hiring after contract award.

Prior to the Contractor voluntarily diverting any of the key personnel to other programs or contracts the

Contractor shall notify the Contracting Officer (CO) and COR within thirty (30) calendar days of the action for approval. The Contractor shall submit a justification for the diversion or replacement, and a request to replace the individual to the COR. The request must substantiate how the proposed replacement's skills, experience, and credentials meet or exceed the skills, experience, and credentials of the outgoing personnel.

If key personnel are removed from the contract or is terminated due to cause or the key personnel separates from the Contractor’s employment voluntarily with less than thirty (30) calendar days’ notice, the Contractor shall provide the maximum notice practicable to the COR. The Contractor shall not divert, replace, or announce any such change to staff without the written consent of the COR.

FOH will decide on how many ACMs are required (with Contractor’s input) for proper oversight of all

FOH SPSs. FOH will ultimately determine which SPSs are assigned to each ACM.

C.19 RESIGNATION/TERMINATION

The Contractor shall maintain a stable workforce. It is unacceptable to FOH to have a high turnover rate of staff. If a PerSC identified as fulfilling steady-state hours leaves or steps-down to PRN status or

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12 | P a g e any other PerSC leaves before one (1) years of service, a disincentive will be assessed to the

Contractor as described in Section C.51.

Low turnover rates create consistency of FOH services to its customers and reduce contract oversight needs. An incentive may be assessed to the Contractor as described in Section C.51 if the Contractor maintains a turnover rate at or below 9% in a set twelve (12) month period. The twelve (12) month period will begin two (2) months after the completion of the contract transition period and repeat every twelve (12) months thereafter.

The Contractor shall notify the COR of all PerSC resignations/terminations within the same business day of the Contractor having received notification or providing action and monthly at time of draft invoice submission. The Contractor shall start recruiting as early as possible to minimize having the position filled with PRN.

C.20 VACANT POSITION

All positions identified on the Site Staffing Plan, whether steady-state or ad-hoc, will be identified as filled with permanent PerSC, PRN PerSC, or remain identified as vacant. Vacant positions identified for both steady-state and ad-hoc hours shall be filled with a PerSC within one (1) business day, unless otherwise identified on the Site Staffing Plan. The Contractor shall ensure there is a PerSC to begin work the next business day of the leaving PerSC. If a permanent PerSC is not available and the

Contractor must recruit for a new PerSC, then the Contractor shall provide PRN PerSC(s) to begin work the next business day of the leaving PerSC until such time as a new PerSC is hired and available to work. The Contractor shall have thirty (30) calendar days to hire and obtain FOH Security

Clearance package acceptance as complete for each new PerSC from receipt date of a PerSC’s resignation letter, email or termination. If, at any time, the Contractor submits incomplete and inaccurate FOH Security Clearance package/s, a daily disincentive will be assessed to the Contractor as described in Section C.51 until the FOH Security Clearance package is accepted as complete.

At a minimum, every month the Government will review the Contractor’s PerSC vacancy fulfillment for the previous month.

NOTE: A resignation/termination of a PerSC does not relieve the Contractor of obligation to properly staff as per the staffing plan. The Contractor shall provide continuity of staff to ensure FOH customer needs are met. The thirty (30) calendar day clock will stop once the Contractor submits an FOH

Security Clearance package as complete for a candidate. The thirty (30) day clock will resume if the

FOH Security Clearance package is rejected/returned to the Contractor as incomplete and will stop again once a new/revised package is submitted to FOH. The clock will be assessed final upon FOH

Security Clearance package acceptance as complete.

C.21 VACANCY REPORT

The Contractor shall deliver a monthly Vacancy Report to the COR at time of draft invoice submission with the following information: site code, position that is vacant, type of hours (steady- state or ad-hoc), date position was/will be vacated, plan to fulfill during interim (i.e., PRN utilization, etc.), date anticipated position will be filled, Area Clinic Manager (ACM) assigned to that site. A disincentive will be assessed to the Contractor as described in Section C.51 until the monthly report is received.

C.22 REASSIGNMENT OF PerSC

The Contractor shall not reassign/move any PerSC without prior approval from the COR. If the

Contractor believes a reassignment/move of a PerSC is necessary, the Contractor shall provide to the

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COR, the same business day, a written justification for the reassignment. The request shall identify the

PerSC to be reassigned, why a reassignment is deemed necessary and the new proposed location for the reassigned PerSC.

C.23 REMOVAL OF PerSC

FOH reserves the right to immediately remove a PerSC from the contract for deficient performance or any behavior that is inconsistent with facility rules or applicable polices and manuals. FOH has a zero-tolerance policy for these types of offenses. The COR will notify the Contractor in writing that a

PerSC needs to be immediately removed from the SPS or duty station. The Contractor shall have the

PerSC removed immediately after notification. The Contractor shall be required to notify the COR when termination of a contractor is imminent for poor direct patient care, particularly when the level of performance warrants disciplinary action on the part of the Contractor. All PerSCs hired during the contract will be under a one (1) year probation period in which FOH reserves the right to remove a

PerSC from the contract for any reason. If key personnel is removed from the contract or is terminated due to cause (i.e. not following policies, procedures, and protocols, not clinically sound, lack of practicing sound judgement, etc.) the key personnel will be restricted from being re-hired with the

Contractor to support future program needs.

C.24 PerSC PERFORMANCE EVALUATIONS

The Contractor shall provide documentation to the COR for an annual performance evaluation for each individual PerSC. The performance evaluation is based on duties and responsibilities and other criteria listed in the JSPD. The performance evaluation criteria shall be approved by the COR at the time a position is filled. FOH reserves the right to determine that a PerSC’s performance is satisfactory or unsatisfactory, regardless of the Contractor’s internal evaluation. PerSCs that fail to meet FOH performance and conduct expectations shall be removed from the contract. The Contractor shall provide a temporary PerSC until a permanent PerSC fills the position.

C.25 STAFF RETENTION SURVEY

PerSCs may be required to respond to an FOH standard retention survey when offered, to assess FOH-wide retention issues. When a PerSC leaves contract service, he/she may be asked to complete an FOH exit survey. All surveys shall be returned directly to the COR. All individual survey results will remain confidential.

C.26 N95 MASK FIT TESTING

The Contractor shall ensure all PerSCs have been fit tested with an FOH approved N95 mask prior to working in any SPS or outreach activity. It is the responsibility of the Contractor to pay for each PerSC to be N95 mask fit tested and maintain their annual certification. Staff are to be fit tested prior to initial working, annually thereafter and when changes occur to the wearer that may affect fit. FOH will supply FOH approved N95 masks in all SPSs for PerSCs to use once initial fit test has been completed and mask type has been identified. In the rare instance that a PerSC cannot pass a fit test with an approved FOH N95 mask supplied in the SPSs, an outside N95 fit tested mask will be accepted given:

1) the N95 mask is a CDC & NIOSH approved, surgical grade mask with no valve and

2) understanding that FOH will not supply the alternative N95 mask. The Contractor will report to the

COR the fit testing documentation and make/model of the mask the PerSC will use before any work is performed and monthly at time of draft invoice submission.

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C.27 REQUIREMENTS (CREDENTIALING/PRIVILEGING)

C.27.1 CREDENTIALING

Prior to credentialing, at a minimum, each PerSC has:

• A current JSPD (updated with the initial and each renewal application),

• A job-specific orientation,

• Site specific training,

• A current state-issued practicing license in any state to work in FOH clinics. The practitioner must not possess a license to practice in any state with past or pending actions, including expunged actions, against the license. Practitioners who have past or pending actions against a license to practice in any state can be presented for credentialing only if the vendor receives written notice from FOH indicating that the practitioner is approved for consideration.

• Relevant past experience,

• Contractor-performed primary source verified credential file, including board- eligibility or certification as applicable,

• Documented competency in their profession,

• Current Basic Life Support - Health Care Provider (BLS-HP) certification.

The Contractor shall compile a complete contractor-performed primary source verified credential file prior to the candidate being submitted to the COR for approval to work under this contract. The

Contractor shall verify that candidates for employment meet all credentialing and security qualifications as dictated by accreditation standards and the Federal Government. The Contractor is required to perform this verification directly or using a Credentials Verification Organization (CVO).

However, primary source verification must be performed according to the requirements of TJC-AC as referenced within FOH policies and procedures for verification of staffing qualifications. If TJC-AC modifies accreditation requirements for staff credentialing, the COR will notify the Contractor of the new requirements. The Contractor shall implement all credentialing process changes within fourteen

(14) calendar days of receiving notification. All current PerSCs will be grandfathered and will have six

(6) months to meet new credentialing standard(s) unless otherwise advised by the COR.

Contractor shall provide to the COR proof of National Registry of Certified Medical Examiners certification for all applicable PerSCs upon contract award and annually thereafter.

Contractor shall provide to the COR a verified National Practitioner Databank/Graduation Report (as applicable) for each PerSC upon contract award and annually thereafter.

The Contractor shall maintain complete and up-to-date credential files as specifically outlined and directed by FOH policies and procedures for all PerSCs. Complete and up- to-date credential files generally include (but are not limited to) the following information identified in Attachment J.5.

The Contractor shall have current licenses, registrations, and required certifications on file for every

PerSC

While PerSCs are not required to have a license for the specific State or District in which they are

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15 | P a g e providing services under this contract, each PerSC shall be familiar with and continue to follow the requirements of State Boards, State Practice Acts, and prevailing local standards of care for the state in which the license is issued and where they provide clinical care.

Note: Some localities require state-specific licenses for certain activities and/or practices. It is required that the Contractor understands and adheres to these provisions.

Credential documents shall meet all applicable national health care quality organization accreditation standards for an organization designated by FOH (currently TJC-AC) and be available for review by accreditation surveyors, Credentialing and Privileging Manager, or the FOH Medical Director at any time within two (2) hours of request.

The COR may request to inspect/review in person or receive copies of any credentialing documentation, national database queries, and primary source verification at any time.

Every credentialing file shall be available for FOH review within the allotted timeframe(s) outlined within FOH policies and procedures. FOH will work with the Contractor to determine an adequate process for credentialing documentation submission, review, and destruction to assure appropriate handling of the personally identifiable information (PII) contained within. All agreements will be obtained in writing.

C.27.2 PRIVILEGING OF LIPs

PerSC LIPs must apply for and be privileged by FOH’s Privileging Review Panel (PRP) and Medical

Director to provide direct care services in SPSs prior to performing any work on this contract, case review, or consulting services.