EXHIBIT_A_Performance_Work_Statement_Final_30Aug.docx

DOI Medical Qualification Determination Services DOI Medical Qualification Determination Services ATTACHMENT A: PERFORMANCE WORK STATEMENT Contents

Section 1.0 General Information

1.1 Scope of Work

The contractor must provide all personnel, equipment, tools, materials, supervision and other items and services necessary to perform Medical Qualification Services for positions with specific medical standards and/or physical requirements pursuant to 5 CFR Part 339. The U.S. Department of the Interior medical standards have been developed to address the arduous and hazardous occupational, functional and environmental requirements of multiple occupations. The medical standards programs serviced under this contract establish the minimum medical requirements and fitness levels considered necessary for safe and efficient performance of the full range of essential functions and ensure medical expectations are applied consistently and uniformly to all applicants and incumbents.

5 CFR 339.205 Medical Evaluation Programs provides for the establishment of periodic examinations to safeguard the health of employees whose work may subject them or others to significant health or safety risks due to occupational or environmental exposure or demands. The corollary DOI policy is promulgated in Department Manual (DM) Part 485 Chapter 18: Occupational Medicine Program. This contract may provide services for all Medical Evaluation Programs within the Department of Interior (DOI). A listing of current Medical Standards Programs can be found on the US DOI Office of Safety and Health website.

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

The goal of this contract is to provide timely access to standardized, quality medical exam services that produce accurate and secure records of annual medical qualification determinations for all DOI positions requiring such. Throughout the life of this contract, the Government may add additional programs on a case-by-case basis with subsequent task orders issued. If additional programs are included, a supplemental PWS may be added through contract modification.

1.2 Contractor Personnel

1.2.1 Key Personnel

1.2.1.1 Key personnel includes the Program Manager and Reviewing Medical Officers (described in Section 4.4 of this PWS).

1.2.1.2 During the first 180 days of performance, the Contractor shall make no substitutions of key personnel unless necessitated by illness, death or termination of employment. In the event a substitution is required, the Contractor shall notify the Contracting Officer (CO) within fifteen calendar days after the occurrence of any of these three events. After the initial period, the Contractor shall submit the information to the CO at least fifteen days prior to making any permanent substitutions. Notification to the CO must include an explanation of the circumstances that necessitate the proposed substitution and documentation that the proposed substitute possesses comparable qualifications to the individual being replaced. The CO will notify the Contractor within fifteen days after receipt of all required substitute's personnel information of any concerns regarding the replacement.

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

1.2.2.1 The program manager or alternate must have full authority to act for the contractor on all matters relating to daily operation of this contract.

1.2.2.2 The program manager or alternate must be available to respond to critical contract management concerns and responsive to designated government personnel within the same business day. For concerns brought forward after normal duty hours, the manager or alternate must be available within 24 hours of expressed concern.

1.2.2.3 The program manager and alternate or alternates must be able to read, write, speak and understand English.

1.2.3 Contractor Employees

The contractor shall be responsible for employing technically qualified personnel to perform the services required by this contract. The contractor shall maintain the personnel, organization and administrative control necessary to ensure the work delivered meets the contract requirements.

1.2.3.1 The contractor must ensure employees and contractors have current and valid professional certifications before starting work under this contract.

HEALTH CARE LICENSING REQUIREMENTS/CREDENTIALS:

· Reviewing Medical Officer Function must be carried out by a Board-Certified Physician, Board certification may be in Occupational, Internal, Family or Emergency Medicine.

· Examining Health Care Provider must be a State Licensed Physician, Physician’s Assistant (PA) or Nurse Practitioner (NP).

1.2.3.2 The contractor must not employ any person who is an employee of the US Government if employing that person would create a conflict of interest. Additionally, the contractor must not employ any person who is an employee of the Department of Interior, unless such person seeks and receives approval according to 18 U.S.C. 207(a).

1.3 Quality Control

1.3.1 The contractor shall establish and maintain a quality control plan that contains, at a minimum, the items listed in this section:

1.3.1.1 Methods to select, recruit, orient, monitor and maintain quality clinics.

1.3.1.2 Methods to measure and monitor all services listed on the performance requirements summary (PRS) to demonstrate the organization’s performance. The description must include specifics as to the areas to be inspected on both a scheduled and unscheduled basis, frequency of inspections, and the title and organizational placement of the inspectors.

1.3.1.3 Methods to identify and manage risks that can affect outputs in the quality of service performed.

1.3.1.4 A description of the records to be kept to document inspections and corrective or preventive actions taken. The records of inspections must be kept and made available, when requested, throughout the contract performance period and for the period after contract completion until final settlement of any claims under this contract.

1.4 Quality Assurance

According to the contract clause entitled 52.212-4 Contract Terms and Conditions -- Commercial Items (a) Inspection/Acceptance of the contract, the government will evaluate the contractor’s performance under this contract. For those tasks listed on the PRS (Technical Appendix 1), the contracting officer’s representative (COR) or evaluators will follow the methods of surveillance specified in this contract. Government personnel will record all surveillance observations. When an observation indicates defective performance, the designated COR will require the program manager or representative to acknowledge the observation. This does not necessarily constitute concurrence with the observations, only acknowledgement that he or she has been made aware of the defective performance. Government surveillance of tasks not listed in the PRS or by methods other than those listed in the PRS may occur during the performance period of this contract. Such surveillance will be done according to standard inspection procedures or other contract provisions. Any action taken by the contracting officer as a result of surveillance will be in accordance with the terms of this contract.

1.4.1 Performance Evaluation Meetings

The contracting officer may require the program manager to meet with the contracting officer, contracting officer’s representatives (CORs), and other government personnel as deemed necessary. The contractor may request a meeting with the contracting officer when he or she believes such a meeting is necessary. Written minutes of any such meetings must be provided by the contractor and signed by the program manager and the contracting officer.

1.5 Hours of Operation

1.5.1 Standard Hours of Operation

The contractor must post their standard hours of operation. The contractor may adjust standard business hours to best serve the population.

1.5.1.1 Holidays. Performance of services will not be required on federally recognized holidays.

1.6 Transition

The phase-in/phase-out periods are necessary to avoid gaps in service, minimize decreases in productivity, and prevent possible negative impacts on services. The six-month phase-in period will be included in ordering year one (1) for the completion of data transfer, security, training and preparatory requirements in accordance with this PWS. The 30-day phase-out period will be included at the end of ordering year four (4) to ensure continuity of service. During these periods, the contractor shall provide key personnel to ensure that the services outlined in this PWS are maintained at the required level of proficiency.

The Contractor shall submit a Phase-In/Phase-out Plan within 10 days of award. The Plan shall address how the Contractor will assume full responsibility for all areas of operation in accordance with the terms and conditions of this contract.

The Phase-In Plan shall include a timeline that includes milestones to ensure the Contractor takes over performance of all contractual responsibilities. The Phase-In Plan shall specify a training program and a date for transferring responsibilities described in the plan.

As part of the phase-in, the Contractor shall provide information on the following:

• Applicable schedules and milestones

• Data transfer process

• FEDRAMP/Authority to Operate (ATO) process

• Provide proof of all certifications and clearances.

•Training program to ensure Government personnel are properly trained prior to the end of the phase-in period.

The Plan shall also include Phase-Out procedures and specify a training program and timeline for transferring responsibilities in the plan. The Contractor shall provide sufficient experienced personnel during the phase-out period to ensure that the services called for by this contract are maintained at the required level of proficiency. The Contractor shall follow their Phase-In/Phase-Out plan and keep the Government fully informed of status throughout transition periods. Throughout the phase-in/phase-out periods, it is essential that attention be given to minimize interruptions or delays to work in progress that would impact the mission. The Contractor must plan for the transfer of work control, delineating the method for processing and assigning tasks during the phase-in/phase-out periods.

Section 2.0 Definitions

2.1 General Definitions

Collateral duty – DOI employees who may have duties assigned in more than one occupation requiring a medical standard qualification (e.g. firefighting and law enforcement).

Fitness-for-duty Exam: A medical examination of a current employee to determine whether the employee is physically or psychologically able to safely perform the essential functions of the job. Fitness-for-duty exams may be required when an employee has a change in health status, such as after taking time off for a serious illness or injury.

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

Final Rule.

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

Medical Qualification: Designation by a licensed medical professional that an individual meets or does not meet all the appropriate medical standards established to perform the essential functions of position in review.

Medical Standards Program: A program that manages qualification against established medical standards for positions where duties are arduous or hazardous, or require a certain level of health status or fitness because the nature of the positions involve a high degree of responsibility toward the public or sensitive national security concerns. Reference 5 CFR 339.202.

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

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

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

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

· the provision of health care to the individual, or

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

Quality Assurance: A planned and systematic pattern of all government actions necessary to provide confidence that adequate technical requirements are established; products and services conform to established technical requirements; and satisfactory performance is achieved. Quality assurance refers to actions by the government assurance functions for a contracted service.

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

Risk Mitigation/Waiver Process: is an inherently governmental function where the DOI evaluates the risks associated with various non-qualifying conditions and determines whether to grant a waiver.

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

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

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

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

Unit Identifier: a code used within a program to uniquely identify a particular government organizational unit. Location of unit identifiers are available in each program section.

2.3 Acronyms

Section 3.0 Government-Furnished Items

3.1 General Information

Except for those items or services specifically stated as government furnished, the contractor must furnish everything needed to perform this contract according to all its terms.

3.2 Government-Furnished Records

The government may furnish records for existing personnel on an individual program basis. Records may include: exams completed in previous years, periodicity and qualification history, and current Risk Mitigation/Waiver documents if available. Specific records and estimated volume to be transferred are listed in each individual program section.

3.3 Government-Furnished Program Orientation

3.3.1 Each MSP serviced under this agreement shall be responsible for providing an initial orientation for all Reviewing Medical Officer (RMO) physicians (contractor personnel), as well as periodic orientation updates, as needed. The initial orientation will consist of field/job observations and in-class briefings to provide RMOs with an experience that demonstrates the essential functions and work conditions of the specific job class and common distinctions in medical qualification determinations. Participating RMOs should be prepared for light hiking and possibly camping at remote field locations. Personal protective equipment will be provided with the exception of boots. Multiple bureaus may coordinate a combined initial orientation as appropriate, such as a multi-day excursion.

3.3.2 After the initial orientation, routine refresher exercises will be provided by each program. Frequency and extent of refresher trainings will be determined by each program with at least 30-days notification to the contractor. When possible, multiple program refreshers can be combined into a multi-day event.

Section 4.0 Specific Tasks

4.1 Medical Qualification Services Background & Scope

4.1.1 Background

The Department of the Interior (DOI) has nine (9) bureaus with multiple programs that support positions requiring minimal medical and/or physical qualifications to perform duties safely and efficiently in accordance with 5 CFR 339. The duties carried out by these key positions across bureaus are integral to the DOI’s mission of protecting America’s natural resources. Although each program is tailored to meet the goals of each bureau, the programs share many of the same business needs with regard to medical services to support their medical and/or physical qualification requirements. The goal of this contract is to provide timely access to standardized, quality occupational medical services, secure private health data tracking capabilities, records management and security in a consistent manner across participating programs.

4.1.2 Program Specific Information

All medical qualification services will be provided as specified in this section unless otherwise noted in program specific supplement.

4.2 Data & Health Record Management

The contractor shall provide secure information systems in accordance with Exhibit B_DOI_IT_Baseline_Compliance Contract Guidelines and Exhibit C OWF_IT Contract Baseline Compliance Requirements, to collect and maintain all procedural and health records generated throughout the processes outlined in this PWS. The system will facilitate intra- and inter-program business coordination and data sharing across all programs as authorized. The information management system must be accessible via secure web portal access twenty-four hours per day, seven days per week, outside of scheduled system maintenance.

4.2.1 Provide a secure web-based portal access to the information system for the secure transmission of PHI and methods for requesting, scheduling, tracking, and documenting all actions described in the PWS.

4.2.2 Provide and maintain role-based access controls for DOI users as outlined in Appendix 3 and each program section to ensure appropriate system access.

4.2.2.1 When relevant, allow users with appropriate authorization to input final disposition of an individual’s clearance status, whether a medical waiver was granted, which type of medical waiver granted, and any supporting records following the medical qualification determination.

4.2.2.2 Allow users with appropriate authorization to print certificate of qualification for examinees who meet all medical standards pertaining to the specific program; or for those qualified via approved waivers.

4.2.2.3 Allow inter-program access by user when authorized by each program section.

4.2.2.4 Provide a method for all Management Official users to accept DOI Rules of Behavior statement and certify completion of DOI Role-based Privacy training annually. System shall prompt users when due and be able to provide reports of completion status.

4.2.2.5 Provide DOI Program Managers the ability to edit (add, remove, change) an Examinee’s or Management Official’s associated units and user access level (See Technical Appendix 3).

4.2.2.6 Provide DOI Program Managers the ability to manually activate and deactivate an Examinee’s or Management Official’s system access.

4.2.3 Create a secure file with a unique identifier other than the Social Security Number for each examinee that will serve to consolidate all process information and health records generated for that individual throughout their career with the respective DOI bureau. Social Security Number will be utilized at initial entry to provide long-term records tracking and ensure no duplicate records are created. Upon initial entry the complete Social Security number will be masked or hidden and only the unique identifier will be visible to users and included in reports.

4.2.3.1 Each individual examinee shall be associated with a Unit Identifier. This association may change throughout an individual's career.

4.2.3.2 For each process or medical record received from any source (pre-exam packet, lab results, schedule request), identify each record received with the individual’s unique identifier and incorporate the record into that individual’s file.

4.2.3.3 Any hard copy records received shall be converted into the information system electronically (scanned or digitized as appropriate).

4.2.3.4 The Contractor will be responsible for transitioning initiation data identified within the PWS during the contract initiation phase; or within 30 days of issuance of bureau or program specific task orders.

4.2.3.5 No more than once annually, the Contractor will be required to export data and provide it to the COR within 30 calendar days of request.

4.2.4 Exam Process information tracking, notification, and reporting

4.2.4.1 Track all requests, contacts, contact attempts, scheduling attempts, scheduled appointments, missed appointments, successful appointments.

4.2.4.2 Track Medical Qualification status and program-specified periodicity of exams for each individual.

4.2.4.3 Notify authorized system users of results upon each Medical Qualification determination. Provide all system users with ability to customize notifications including option(s) to opt in/opt out.

4.2.4.4 Notify individuals and authorized system users of upcoming periodicity expirations. Provide all system users with ability to customize notifications including option(s) to opt in/opt out. Ensure DOI authorization is received prior to scheduling periodic exams.

4.2.4.5 Provide periodic reports on process metrics detailed in Technical Appendix 4.

4.2.5 Health Data Information Tracking and Reporting

4.2.5.1 The information system must have the capacity to report on all exam data elements captured at each exam throughout the contract period to produce individual and workforce health status data.

4.2.5.1.1 The Contractor shall confirm trackability of all exam data elements during contract initiation phase and present to DOI MSP the configuration for consistent, standardized data collection and reporting.

4.2.5.2 The Contractor shall provide periodic workforce health outcome status reports as requested by DOI as outlined in Technical Appendix 4.

4.2.6. Transfer of Records and Data at Contract Termination

4.2.6.1 At contract termination, the contractor will securely transfer all records in accordance with contract clauses 52.227-17 Rights in Data – Special Works and 52.237-3 Continuity of Services.

4.2.7 Information System User Support

4.2.7.1 Provide customer support responsive to all scheduling, tracking and medical record access and status inquiries and needs.

4.2.7.2 Provide multiple methods to access customer support (e.g., phone, email, chat, web portal) for common inquiries at all times.

4.2.7.3 Ensure business hours are clearly communicated via all customer support access points and respond to all customer inquiries within one business day.

4.2.7.4 Provide training and/or tutorials on information system functionality, web portal access and navigation training to authorized users that is readily accessible on an ongoing basis.

4.2.7.5 Establish procedures for system access requests and validation and training access for all authorized users. Training should be customized for each user type and functional need.

4.3 Medical Exams

4.3.1 Exam Requests - Approximately 1200 designated DOI requesting officials will request exams through the secure web-based portal.

4.3.1.1 Within two business days of the request, the Contractor shall verify the requested exam type for appropriate periodicity and attempt to contact the examinee.

4.3.1.2 Contractor shall make four documented attempts to contact examinee using all available contact information. If contact attempts are unsuccessful, the Contractor shall notify the requesting official to verify contact information. If new or corrected contact information is provided, the contractor shall make an additional four documented contact attempts. Following four documented contact attempts with validated contact information, the requesting official must be notified and it is incumbent on the examinee to contact the contractor for scheduling. If examinee does not contact the contractor within 10 business days, the requesting official will submit a new request if needed.

4.3.2 Exam Scheduling - Within four business days of the examinee response, the Contractor shall schedule all required exam components at no more than two locations in the same day within 75 road miles of the examinees’ identified location.

4.3.2.1 The contractor may split exam components among two facilities or clinics. Where scheduling at two facilities occurs, the contractor shall:

· Ensure the facilities are within a reasonable distance such that no more than 60 minutes is added to the exam execution.

· Provide advance notice to the examinee and provide clear direction of times, locations, and procedures required at each facility.

4.3.2.2 If the exam is scheduled at a location other than the closest location available to the examinee, whether for contractor convenience or due to examinee availability, the contractor will offer the alternatives and confirm with examinee prior to scheduling the exam.

4.3.2.3 In the event all exam components cannot be provided within a 75 road mile radius and the nearest available clinic is outside a 100 mile radius, contact the COR within two-days of the request to provide alternate cost-effective solutions to complete all exam components. The COR shall evaluate the proposed solution and involve the requestor and/or CO to assess additional task orders or modifications.

· If a proposed solution is approved, the exam requestor or COR will communicate such and ensure appropriate documentation to proceed with alternate scheduling arrangements is provided to the Contractor.

· If a proposed solution is not approved, Contractor will work with the requestor and COR to reach an acceptable solution.

4.3.3 Pre-examination packet - The Contractor will verify and update examinees’ information during the scheduling process and provide direction for the completion of the pre-examination packets.

4.3.3.1 Utilizing the sample form provided for collecting medical history in Attachment 2 Sample Medical History Questionnaire, the contractor shallprepare a medical history pre-examination form for examinees in a format that is most conducive to the user and process flow. Contractor-defined forms may be utilized with DOI approval.

4.3.3.2 The contractor shall provide the pre-examination packet to the examinee for their completion within two business days of exam scheduling. The pre-examination packet may be completed via a secure web portal. For instances where the examinee cannot access the internet, the packet shall be made available to the examinee. In both cases the examinee must be provided adequate time to complete the packet prior to the scheduled exam. The examinee will be expected to follow all instructions provided therein, inclusive of contacting the clinic to confirm their appointment and bringing all required documentation to their appointment.

4.3.4 Medical Exam

4.3.4.1 Contractor will ensure a Licensed Physician, Physicians’ Assistant or Nurse Practitioner reviews the completed pre-examination packet and any supporting documentation with the examinee at the exam appointment.

4.3.4.2 Licensed Health Care Providers will complete all components of the requested examination type and any ancillary services ordered in accordance with Technical Appendix 2.

4.3.4.3 Contractor will ensure all completed exam components are compiled, appropriately documented and submitted to the Reviewing Medical Officer (RMO) for qualification determination.

4.3.4.4 Retesting due to clinical errors shall be performed at no charge. Clinical errors are those resulting solely from carelessness or negligence of the clinical staff and any associated sub-contractor of the clinic.

4.3.4.5 In the event of missed appointments, notify requesting official of missed appointments within three (3) business days of the scheduled appointment.

4.3.5 Self-Certification and Screening

4.3.5.1 Annual Self-certifications - Provide a method for medically qualified individuals to certify no changes in health status since the last medical examination. Self-certifications indicating a change in health status or providing additional information will require a self-certification review.

4.3.5.2 Pre-Fitness Screening - Provide a method for individuals to access and complete a health screening questionnaire.

4.3.5.3 Annual Self-certifications and Pre-fitness Screenings will not be ordered but shall be available at any time for examinees to access via the web-based portal. If appropriate responses are given, qualification certificates will be provided upon completion.

4.3.6 Fitness for Duty Exams

At the bureau program’s request RMO physicians will work on a case-by-case basis to review written and/or verbal synopsis of observed or documented conditions including psychological conditions. The RMO will provide recommendations on appropriate medical specialty to perform a fitness for duty examination. The Contractor will arrange an appointment for the examinee with the identified specialist at the nearest possible location and provide guidance regarding the focused examination in relation to the examinee’s ability to safely perform the essential functions of the job.

Actual exam costs will be proposed separately in each case and authorization provided by the COR prior to scheduling an appointment.

4.3.7 Payment to Exam Provider

4.3.7.1 The Contractor shall guarantee payment for exam services scheduled under this contract and ensure no personal insurance information or payment is collected from examinees scheduled under this contract. Reconciliation of any unauthorized billing of examinees will be initiated within three (3) business days of notification. Final resolution of unauthorized examinee billing will be made within 30 calendar days.

4.3.7.2 The Contractor shall provide timely payment to the exam provider and invoice the government for all medical exams requested and verified by the government under this contract. Where the provider is a small business, payment shall be made in accordance with contract clause 52.232-40, Providing Accelerated Payments to Small Business Subcontractors.

4.4 Medical Review & Qualification Determination

4.4.1 The contractor shall establish a centralized Reviewing Medical Officer (RMO) function carried out by a minimum of one Board Certified Physician that is independent of the licensed health care providers conducting the medical exams. Reviewing Medical Officer Function must be carried out by a Board Certified Occupational Health Physician, Internist, Family, or Emergency Medicine Physician. The RMO function is national in scope. The contractor must adequately staff the RMO function with capacity to adhere to the specified timeframes for completing reviews for all DOI Programs (sometimes with simultaneous needs).

4.4.2 Reviewing Medical Officer Orientation: RMO physicians attesting to qualification determinations must complete a program specific coordinated Medical Standards Program orientation and annual refresher training (reference Section 3.3 of this PWS).

4.4.3 The RMO function will review all records resulting from exams against the Medical Standards appropriate for the position as well as any current or historic waivers and make a medical qualification determination. The RMO physician(s) shall attest to the validity of every qualification determination. Medical Standards for participating bureau programs will be identified by each program supplement.

4.4.4 The Contractor will provide medical review of non-participatory exams and associated qualification determinations. These are exams not completed by the contractor but submitted directly by Bureau programs provided that all necessary exam components are compiled, completed within the last 12 months, and appropriately documented. Examples may include examinees entering a DOI program with a recent exam completed through another agency or program.

4.4.5 Qualification Determination

4.4.5.1 Within twelve (12) business days of the exam, the Contractor shall document and communicate the findings of the medical review to the examinee and the requesting Management Official.

Findings of the medical review shall clearly indicate qualification determination or additional information is needed. The Contractor must ensure qualification determinations meet the specific requirements outlined in each program section.

For examinees meeting all standards and for examinees not meeting standards that have an appropriate approved waiver, the Contractor shall make a printable certificate of qualification available to the examinee and the Bureau program or their designee through the Contractor’s system.

In addition, separate from the qualification results, during exam years the examinee will be provided with a brief health status summary that also highlights any significant issues captured during the exam that may not have reached the medical standard threshold. The contractor shall format the health summary to clearly show how health has changed since baseline.

4.4.5.2 In the event that further clarification of health status is required from the examinee in order to make a “Medically Qualified” determination or make a static and stable determination, the Contractor shall notify the examinee that additional information is needed to make a determination. The Contractor shall allow the examinee ten (10) business days to submit requested clarifying documentation prior to the Contractor making a qualification determination. Upon receipt of documentation submission, the Contractor shall make the qualification determination within two (2) business days. If sufficient documentation is not submitted within the allowable 10 business days, the Contractor shall document non-responsiveness and issue a “Not Medically Qualified” determination.

4.4.5.3 The contractor will provide a limited medical review and qualification determination for examinees submitting additional documentation after receiving an unqualified determination. These situations may include: short term conditions that have resolved and the firefighter is able to resume arduous duty without limitations, and/or documentation on chronic conditions that are not likely to change and if determined static and stable may improve the examinees chances of receiving an agency provided waiver.

4.4.6 Medical Consultations

4.4.6.1 At the bureau program’s request the RMO will be available for general consultation on various bureau medical program issues (e.g. creation of examinee forms, complex medical cases and assistance with medical review boards).

4.5 Rural/Remote locations and Mobile Medical Unit Deployment

4.5.1 The Contractor must have the ability to provide mobile medical (onsite) services at a minimum rate of 45 comprehensive and/or periodic exams a day usually in remote locations. A bureau program may authorize a mobile medical unit approach when circumstances exist (i.e. extremely remote areas, inadequate clinic coverage, large volumes, etc.) where it is more efficient to complete exams onsite. Due to logistical considerations, the provision of medical exam services as described in this section will be negotiated as a separate Task Order as needed throughout the contract period by bureau programs. As such, mobile medical exam services as described in this section shall be addressed and priced separately.

4.5.2 The contractor may deploy mobile medical teams to complete any exams.. The contractor will develop a resource list to include specialty personnel necessary to complete a minimum of 45 comprehensive and/or periodic exams daily. The Contractor must also be able to scale the resource list to provide a la carte mobile options to meet specific needs of bureau programs that may include more or less exams than the required minimum. Telemedicine technology may be utilized in isolated situations, with DOI approval, when in-clinic and on-site medical services are not suitable.

4.5.3 Use of telemedicine technology and/or deployment of mobile medical teams shall be coordinated with the COR. Each mobile medical team deployment shall be separately negotiated within the pricing parameters established at contract award in the price schedule and ordered in accordance with contract clause 52.216-18.

4.6 Medical Qualification System Initiation by Program

4.6.1 For each medical program, within the time specified in the initial Task Order award, the contractor shall implement and test all systems necessary to execute all aspects of the Performance Work Statement and the program-specific requirements nationally.

4.6.1.1 At the contractor’s place of performance, and within ninety days of the initial task order award, the contractor will demonstrate the process flow and information system security as designed for the DOI MSP, collect and integrate DOI MSP feedback into process flow for system testing. The demonstration review and feedback collection should occur within a period of three business days and may be offered via webinar or in person.

4.6.1.2 With a national sample for each program provided by the DOI, the contractor shall conduct and test all components of the system. The individuals in the sample provided will be guided through the system as designed to ensure all aspects of the Performance Work Statement are functioning at the desired quality level.

4.6.1.3 At the conclusion of the system test, the contractor will provide a system test report that will include:

· methods of security testing;

· results of security testing;

· a listing of all items produced and tested;

· what risks arose;

· what items were more complex than originally planned;

· what tests were run, passed, or failed;

· how many defects were logged;

· whether defects or deficiencies were resolved;

· schedule for resolving any outstanding deficiencies or issues; and summary of system readiness for national implementation.

4.6.2 The Contractor shall import system initiation medical qualification records detailed in each program specific supplement to this PWS.

4.6.3 The Contractor shall complete Reviewing Medical Officer Orientation as described in section 3.3 of this PWS.

4.6.3.1 Within 180 days of contract award, up to six (6) Reviewing Medical Officers (RMO) will participate in a three-day orientation provided by participating DOI programs. Actual date and location of the training will be scheduled with consideration to ongoing activities in each occupational group and availability of personnel.

4.6.4 Within 120 days of contract award, the Contractor shall demonstrate subcontracting plan implementation listing all pending, executed and planned clinic agreements and other subcontracts and progress toward plan goals in accordance with contract clauses 52.219-9.

Section 5. Applicable Publications

5.1 Publications

Mandatory publications that apply to this PWS are:

· DOI Medical Standards - All DOI Medical Standards will initially be submitted with each program supplement.

Mandatory publications are also listed in Exhibit B_DOI_IT_Baseline_Compliance Contract Guidelines Systems Security & Privacy Compliance Requirements and Exhibit C OWF_IT Contract Baseline Compliance Requirements. The contractor is obligated to follow those publications designated as mandatory to the extent specified in other sections of this PWS. The contractor must be guided by those publications or use those forms designated as informational to the extent necessary to accomplish requirements in this PWS. Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract. The contractor must immediately implement those changes that result in a decrease or no change in the contract price and notify the contracting officer in writing of such change. Should a decrease in contract price be anticipated, the contractor must provide a proposal for a reduction in the contract price to the contracting officer. Before implementing any change that will result in an increase in contract price, the contractor must submit to the contracting officer a price proposal within thirty (30) days following receipt of the change by the contractor. Failure of the contractor to submit a price proposal as stated herein would entitle the government to performance in accordance with the change at no increase in contract price.

Technical Appendices Technical Appendix 1.0 Performance Requirements Summary

1.1 Performance Requirements Summary

Contractor Records

problems within 48 hours.

Contractor Records

Contractor Records

Contractor Records

Contractor Records

4.3.4.4 Retesting

Contractor Records

Contractor Records

1.2 Government Quality Assurance

Contractor performance will be monitored with each invoicing period to determine if it meets the contract standards. The following quality assurance methods may be used.

· One hundred percent inspection of the output.

· Periodic inspection of the processes or output.

· Customer Feedback

· Statistical random sampling of recurring service outputs using a statistically based sampling procedure as follows:

Where the sample size is less than 50, there will be one hundred percent inspection of all records in the invoice period.

1.3 Performance Evaluation

Pursuant to clause 52.212-4(a) Inspection/Acceptance, the Government reserves the right to inspect or test any services that have been tendered for acceptance. The Government may require reperformance of nonconforming services at no increase in contract price. If reperformance will not correct the defects or is not possible, the government may seek an equitable price reduction.

Performance of service will be evaluated to determine whether or not it meets the performance requirements of the contract. When a performance requirement listed in the Performance Requirement Summary is not met, the government may reduce the price of the deficient performance requirement as described in section 1.4 of this document.

For any non-conforming service, a Performance Assessment Report (PAR) may be issued to the contractor by the Contracting officer. The contractor must respond to the PAR and return it to the contracting officer within the time specified. Upon evaluation of the contractor’s response to a PAR, the contractor may be required to take corrective action or re-perform the task or service.

Interim and final performance assessments will be documented in the Contractor Performance Assessment Reporting System as described in Section 2 of this contract.

1.4 Contractor Payment

For service that meets the performance requirements, the contractor must be paid the full price indicated for the contract line item.

If performance of a service fails to meet the performance requirement for a service surveilled by statistical random sampling or 100% inspection, the contracting officer may deduct from 0% to 5% from an invoiced line item to reflect full conformance or substantial conformance with the contract requirements. The government will calculate payment as follows:

For those services that are performed less frequently than monthly, the payment computation will be determined for the entire surveillance period and will be based on the total maximum payment available for the entire surveillance period.

Any deductions from payment must be taken from the payment from the month in which the contracting officer makes the determination that deduction is appropriate, regardless of the period in which the performance occurred.

Technical Appendix 2 –Medical Exam Types and Required Components

The types of exams and the required components of each to be offered under this contract are detailed in this Technical Appendix. The standard exam periodicity for DOI programs is an initial comprehensive exam, periodic exams every 3 years, supplemented by self-certifications during non-exam years. The Basic exam, Fitness for Duty Exams and Pre-fitness screenings will be used as needed. Program specific requirements vary and are detailed in the program supplements to this PWS.

1. Self-Certifications

a. Annual Self-certification: In non-exam years, the Contractor shall provide a method for users to access and complete self-certification. Users must self-certify no changes in medical condition since the last medical examination.