EXHIBIT_A_PWS_Supplements_Combined.docx

PWS Attachment A Program Specific Supplement 1:

Wildland Firefighters

DOI Wildland Firefighters – Program Background

The Department of Interior (DOI) Wildland Fire Medical Standards Program contains four federal bureaus that employ firefighting professionals to help carry out the mission of protecting America’s natural resources. The Bureau of Indian Affairs (BIA), Bureau of Land Management (BLM), US Fish and Wildlife Service (FWS) and the National Park Service (NPS) employ ~ 14,000 arduous duty wildland firefighters and ~ 1,000 support personnel with light or moderate fitness ratings. The safety of our workforce and the public is the first priority in all fire management plans and activities. As such, DOI Medical Standards Program (MSP) established medical standards policy and requirements for all arduous, light and moderate fitness rated positions. The goal of this contract is to help carry out these medical requirements consistently across bureaus. Medical qualification service for DOI Firefighters will be carried out in accordance with the PWS and the program specific requirements outlined in this section.

Data & Health Record Management

Occupational Electronic Health Records for DOI Firefighters have been collected since 2014. No hard copy records are currently maintained for this program.

Firefighter profiles must have capability to identify Administratively Determined/ Emergency Firefighter (AD/EFF) employment type (must be reportable) and whether an individual is eligible to be seen at an Indian Health Service clinic.

Notification of periodicity expirations shall be made as follows:

· Examinee shall be notified at 60 days and at 30 days prior to the expiration (three years from exam date) of their most recent exam.

· Examinee shall be notified 5 days prior to the expiration (12 months) of their most recent self-certification or exam.

Medical Exams

1. The Contractor shall review their clinic network and make every attempt to utilize Indian Health Service clinics at contract initiation. In subsequent years, contractor will make additional attempts if new information is received. If an IHS clinic is willing, capable of performing all exam components and is optimal with regard to the proximity of the examinee, the IHS clinic must be used.

2. Pre-fitness Screening - Light / Moderate Duty Fire Support Personnel:

Light/Moderate Health Screening Questionnaire (HSQ) annually in accordance with PWS Technical Exhibit 2. The Light/Moderate Health Screening Questionnaire (HSQ), instructions for evaluation, and light and moderate work capacity assessment will be provided by the DOI. Individuals with significant health disclosures will be required to submit additional information for Reviewing Medical Officer (RMO) review. Subsequent disclosures of the same significant health information by these individuals on future Light/Moderate HSQs will not require additional information for review unless deemed necessary by the reviewing medical officer. A method to identify previous disclosures and any changes in health status will be included as part of the screening. Status of completed screenings will be available via the data management system to authorized users.

3. Medical exams are required as stated in PWS Technical Appendix 2 with the following exceptions:

a. Offer Tetanus vaccination booster for examinees in need based upon the date of last vaccination (every ten years) and document examinees vaccination or denial of vaccination.

4. Additional Qualification Determinations which may be requested, dependent on employee/applicants’ collateral duty requirements:

a. Tower Climber Determination

b. OSHA Respirator Determination

5. Periodicity

a. Arduous Duty Wildland Fire:

i. Comprehensive exam - required for initial/baseline exam, additional comprehensive exams (such as exit exams) may be authorized by DOI program management.

ii. Periodic exam - every three years

iii. Self-certification annually in non-exam years. Multiple self-certifications may be completed by examinees within non-exam years.

6. Seasonal Demand:

Exams and self-certifications may occur year-round nationwide. However, peak volume occurs between February and May primarily in the western states. Approximately 60% of exams are conducted during this period.

Medical Review & Qualification Determinations ARDUOUS DUTY: Upon review of exam against the Federal Interagency Wildland Fire Medical Qualification Standards, https://www.doi.gov/sites/default/files/documents/2024-03/federal-interagency-wildland-firefighter-medical-standards-20150112-508.pdf, a RMO shall make one of the following qualification determinations:

Medically Qualified: Designation by a licensed medical professional an individual meets or exceeds all the interagency wildfire medical standards established to perform the essential functions of the position.

Not Medically Qualified: examinee does not meet one or more of the interagency wildfire medical standards. All non-qualified individuals are referred back to the agency to undergo agency risk assessment and receive a risk mitigation/waiver if demonstrated they can still perform safely with a non-qualifying condition. A Not Medically Qualified determination must specify the following: a) standard not met; b) whether the non-qualifying condition is static and stable; c) any recommendation on potential occupational mitigations that would enable the firefighter to still perform safely with non-qualifying condition. A list of current mitigations for frequent non-qualifying conditions will be provided during the initiation period.

Qualified with Risk Mitigation/Waiver: examinee does not meet one or more of the Federal Interagency Medical Standards for Arduous Duty, but through risk assessment, agency review and approval the examinee has been qualified with:

· Waiver w/Risk Mitigation - places specific requirements on the wildland firefighter to reduce the risk associated with the non-qualifying medical condition; or

· Waiver - Waives requirement to meet a medical standard when there is sufficient evidence the wildland Firefighter can perform the essential functions of the job safely and efficiently, without endangering the health and safety of the individual or others.

The Contractor shall have a method for DOI MSP to upload risk mitigation/waiver documents into the system. Upon receipt of the updated documents the contractor will update the system of record from “Not Medically Qualified” to “Qualified with Risk Mitigation/Waiver”.

Self-certification Determinations Self-certifications are completed during non-exam years or after significant change in health status. Only those examinees certifying a change in health status or submitting additional information will require review and must be reconciled with the examinee. The contractor shall make the appropriate qualification determination and a printable certificate available for qualified examinees.

Light and Moderate Duty Pre-Fitness Screening Medical clearances are required for Light or Moderate Duty Work Capacity (Fitness) Tests, defined as:

Moderate – “Duties involve field work requiring complete control of all physical faculties and may include considerable walking over irregular ground, standing for long periods, lifting 25 to 50 pounds, climbing, bending, stooping, squatting, twisting, and reaching. Occasional demands may be required for moderately strenuous activities in emergencies over long periods. Individuals usually set their own work pace.” (National Wildfire Coordinating Group (NWCG) 310–1.

The field test is a job-related test of work capacity designed for those with moderately strenuous duties. It consists of a 2mile hike with a 25-pound pack. A time of 30 minutes, the passing score, approximates an aerobic fitness score of 40.

Light – “Duties mainly involve office-type work with occasional field activity characterized by light physical exertion requiring basic good health. Activities may include climbing stairs, standing, operating a vehicle, and long hours of work, as well as some bending, stooping, or light lifting. Individuals almost always can govern the extent and pace of their physical activity.” (NWCG 310–1)

The walk test is designed to determine the ability to carry out light duties. It consists of a 1-mile test with no load that approximates an aerobic fitness score of 35. A time of 16 minutes, the passing score for the test, ensures the ability to meet emergencies and evacuate to a safety zone. The instructions for the pack test also apply to the field and walk tests.

The Contractor will review pre-fitness health screenings for light or moderate fitness testing (Light or Moderate duty fitness test must be specified) and shall make one of the following qualification determinations:

Cleared - no significant limitations to completing the light or moderate Work Capacity Test (WCT).

Not Cleared - Significant limitation to completing the light or moderate WCT. Additional information is required for clearance.

If additional health information is required to make a determination based on participant responses, participant will be prompted to provide a letter or signed referral document from their personal health care provider or specialist indicating no limitations to participation in the relevant work capacity test. The Contractor will provide a medical review of the documentation and make the appropriate determination. A printable certificate will be made available for cleared personnel.

Rural/Remote Locations and Mobile Unit Deployment The Fire Program requires an average of three to four (3-4) mobile unit deployments including 200-250 medical examinations each year. These exams will be completed in rural, often remote areas, including tribal locations.

Program Initiation

a. Approximately 15,000 examinee profiles with limited electronic health records consisting of previous qualification information, exam and qualification dates, and risk mitigation/waiver will be transferred. Approximately 25% of examinee records will have waiver documents to upload. The Contractor must upload this information into the system of record and establish a seamless transition that aligns previous periodicity and qualification status, including previous waivers with future qualification determinations.

b. There will be approximately 1000 designated wildland fire ordering officials. A list of currently known ordering officials and associated unit identifiers will be provided upon award.

c. RMO Orientation & Refreshers - The Department of Interior Wildland Firefighter Medical Standards Program shall provide initial orientation for Reviewing Medical Officer Physicians (RMOs) (contractor personnel) consisting of a multi-day field exercise including in-class briefings and field observations to provide participants with an experience that demonstrates the essential functions and work conditions of arduous duty wildland firefighters and common distinctions in medical qualification determinations. Participating RMOs should be prepared for light hiking and camping at a remote fire camp. Tents and personal protective equipment will be provided with the exception of boots.

After the initial orientation, the Department of Interior Wildland Firefighter Medical Standards Program will provide periodic refresher training in accordance with PWS Section 3.3.

d. Initiation development and testing - within 180 days of award the program will meet with the contractor on site to review process flows, system security and provide feedback. Within 90 days post meeting the system will be tested with up to 200 firefighters and up to 50 system users. Upon completion of qualification determinations, all reports indicated in Technical Appendix 4 must be available. Upon completion of testing the DOI MSP will provide additional feedback.

PWS Attachment A Program Specific Supplement 2

Bureau of Land Management (BLM) Law Enforcement

Background

The BLM employs approximately 200 law enforcement rangers (uniformed officers) and approximately 70 special agents (criminal investigators) on staff who promote safety, security, and environmental protection of public lands, public land users, and employees. For example, BLM law enforcement rangers and agents regularly engage with their State and local counterparts to investigate wildland arson, mineral resource theft, hazardous materials dumping, archaeological and historical artifact and paleontological theft, and illegal marijuana cultivation.

BLM law enforcement officers also work closely with State agencies and county law enforcement offices to protect public safety for large-scale recreational events, including the King of the Hammers off-road race in southern California, Burning Man festival in Nevada, and a variety of off-highway vehicle races in California’s Imperial Sand Dunes and Utah’s Little Sahara Sand Dunes.

Finally, BLM-managed public lands include nearly 200 miles directly along the international boundary in New Mexico, Arizona, and California. Along international boundaries, the BLM helps protect the public lands along the border through innovative initiatives and partnerships with federal, state and county agencies. These efforts are producing tangible results in the areas of illegal smuggling, resource protection, and identifying transnational threats. In Arizona, for example, off-road travel, littering, and vandalism associated with illegal border crossings threatens fragile desert ecosystems and poses risks to visitor safety.

Data & Health Record Management

No hard copy records are currently maintained for this program. Occupational Electronic Health Records for BLM Law Enforcement Officers (LEO) have been collected by Federal Occupational Health. Approximately 300 examinee profiles with limited electronic health records consisting of previous qualification information, exam and qualification dates, and risk mitigation/waiver will be transferred at program initiation. BLM LEO profiles must have capability to identify whether an individual is eligible to be seen at an Indian Health Service clinic.

Notification of periodicity expirations shall be made as follows:

1. Examinee shall be notified at 60 days and at 30 days prior to the expiration (three years from exam date) of their most recent exam.

1. Examinee shall be notified 5 days prior to the expiration (12 months) of their most recent self-certification or exam.

Medical Exams

1. Medical exams are required as stated in PWS Technical Appendix 2 with the following adjustments:

0. Offer Tetanus vaccination booster for examinees in need based upon the date of last vaccination (every ten years) and document examinees vaccination or denial of vaccination.

0. With every Comprehensive and Periodic Exam, an OSHA Respiratory Questionnaire shall be included.

0. With every Comprehensive Exam, the following labs should be added:

2. Acetylcholinesterase

2. Lab Urinalysis

0. Intake or examinee profile must indicate whether individual is a Firearm Instructor. IF the examinee is a Firearm Instructor, Blood Lead and ZPP must be tested annually.

3. Blood Lead and ZPP (firearm instructors only)

3. Results of annual labs must be sent to the examinee and supervisor annually.

1. Periodicity

1. Comprehensive exam - required for initial/baseline exam only.

1. Periodic exam - every three years

1. Firearm Instructions require Blood Lead and ZPP labs annually

1. Self-certification annually in non-exam years. Multiple self-certifications may be completed by examinees within non-exam years.

Medical Review & Qualification Determinations

LAW ENFORCEMENT DUTY: Upon review of exam against the BLM Law Enforcement Medical Qualification Standards, RMO shall make one of the following qualification determinations:

Medically Qualified: Designation by a licensed medical professional an individual meets or exceeds all the interagency law enforcement medical standards established to perform the essential functions of the law enforcement position.

Not Medically Qualified: examinee does not meet one or more of medical standards. All non-qualified individuals are referred back to the agency to undergo agency risk assessment and receive a risk mitigation/waiver if demonstrated they can still perform safely with a non-qualifying condition. A Not Medically Qualified determination must specify the following: a) standard not met; b) whether the non-qualifying condition is static and stable; c) any recommendation on potential occupational mitigations that would enable the LEO to still perform safely with non-qualifying condition. A list of current mitigations for frequent non-qualifying conditions will be provided during the initiation period.

Qualified with Risk Mitigation Waiver or Waiver: examinee does not meet one or more of the BLM Law Enforcement Medical Standards, but through risk assessment, agency review and approval the examinee has been qualified with either:

1. Risk Mitigation - places specific requirements on the law enforcement officer to reduce the risk associated with the non-qualifying medical condition; or

1. Waiver - Waives requirement to meet a medical standard when there is sufficient evidence the law enforcement officer can perform the essential functions of the job safely and efficiently, without endangering the health and safety of the individual or others.

The Contractor shall have a method for DOI MSP to upload risk mitigation/waiver documents into the system. Upon receipt of the updated documents the contractor will update the system of record from “Not Medically Qualified” to “Qualified with Risk Mitigation/Waiver”.

Additional Determinations Exam requests for BLM LEOs may also include requests after a significant change in health status for Wildland Firefighter (WLFF) qualification determinations. Law enforcement officers receiving a WLFF determination will follow the direction and requirements of the WLFF Supplement 1 as it relates to self-certification during non-exam years. Pre-fitness clearances according to WLFF Supplement 1 must also be made available to BLM LEOs.

Rural/Remote Locations and Mobile Unit Deployment The BLM Law Enforcement Program will not require mobile events.

Program Initiation

1. The BLM Law Enforcement Program will be one of three programs to be initiated within the first six months of contract performance.

1. Approximately 270 examinee profiles with limited electronic health records consisting of previous qualification information, exam and qualification dates, and risk mitigation/waiver will be transferred. The Contractor must upload this information into the system of record and establish a seamless transition that aligns previous periodicity and qualification status, including previous waivers with future qualification determinations.

1. There will be approximately 3 designated BLM Law Enforcement ordering officials. A list of currently known ordering officials and associated unit identifiers will be provided upon award.

1. RMO Orientation & Refreshers - The BLM Law Enforcement Program shall provide initial orientation for Reviewing Medical Officer Physicians (RMO) (contractor personnel) consisting of a multi-day field exercise including in-class briefings and field observations to provide participants with an experience that demonstrates the essential functions and work conditions of Uniformed Officers and Criminal Investigators. Participating RMOs should be prepared for light hiking and remote locations. After the initial orientation, the BLM Law Enforcement Program will provide periodic refresher training in accordance with PWS Section 3.3.

1. Initiation development and testing - within 30-days of initial task order, the program will meet with the contractor on site to review process flows and provide feedback. Within 20-days post meeting the system will be tested with up to 200 LEOs. Upon completion of qualification determinations, all reports indicated in Technical Appendix 4 must be available. Upon completion of testing the DOI MSP will provide additional feedback.

PWS Attachment A Program Specific Supplement 3:

BLM Communication Tower Climbers

Background The Bureau of Land Management Communications Tower Climbing Program regards safety and health as the primary consideration in any job and is committed to preventing job-related accidents and illnesses by establishing and adhering to a Tower Climbing Medical Standards Program (TCMSP). The goal of this contract is to help carry out the TCMSP consistently across the bureau and assist with management of employees who have collateral duties with wildland fire and potentially other DOI arduous positions. Services for BLM TCMSP will be carried out in accordance with the PWS and the program specific requirements outlined in this section.

Data & Health Record Management No hard copy records are currently maintained for this program.

Notification of periodicity expirations shall be made as follows:

1. Examinee shall be notified at 60 days and at 30 days prior to the expiration (three years from exam date) of their most recent exam.

1. Examinee shall be notified 5 days prior to the expiration (12 months) of their most recent self-certification or exam.

Medical Exams

1. Medical exams are required as stated in PWS Technical Exhibit 2 with the following exceptions:

0. Offer Tetanus vaccination booster for examinees in need based upon the date of last vaccination (every ten years) and document examinees vaccination or denial of vaccination.

1. Periodicity

1. Tower Climbers:

0. Comprehensive exam - required for initial/baseline exam only.

0. Periodic exam - every three years

0. Self-certification annually in non-exam years. Multiple self-certifications may be completed by examinees within non-exam years.

Medical Review & Qualification Determinations

Tower Climbers: Upon review of exam against the Tower Climber Standards, Reviewing Medical Officer (RMO) shall make one of the following qualification determinations:

Medically Qualified: Designation by a licensed medical professional an individual meets or exceeds all the Tower Climber medical standards established to perform the essential functions of the position.

Not Medically Qualified: examinee does not meet one or more of the Tower Climber medical standards. All non-qualified individuals are referred back to the agency to undergo agency risk assessment and receive a risk mitigation/waiver if demonstrated they can still perform safely with a non-qualifying condition. A Not Medically Qualified determination must specify the following: a) standard not met; b) whether the non qualifying condition is static and stable; c) any recommendation on potential occupational mitigations that would enable the Tower Climber to still perform safely with non-qualifying condition. A list of current mitigations for frequent non-qualifying conditions will be provided during the initiation period.

Qualified with Risk Mitigation Waiver or Waiver: examinee does not meet one or more of the Tower Climber Medical Standards, but through risk assessment, agency review and approval the examinee has been qualified with either:

1. Risk Mitigation - places specific requirements on the Tower Climber to reduce the risk associated with the non-qualifying medical condition; or

1. Waiver - Waives requirement to meet a medical standard when there is sufficient evidence the Tower Climber can perform the essential functions of the job safely and efficiently, without endangering the health and safety of the individual or others.

The Contractor shall have a method for Tower Climbers to upload risk mitigation/waiver documents into the system. Upon receipt of the updated documents the contractor will update the system of record from “Not Medically Qualified” to “Qualified with Risk Mitigation/Waiver”.

Note: An exam completed through the Tower Climber Program may also be reviewed against any other DOI program standard covered under the scope of this contract.

Self-certification Determinations

Self-certifications are completed during non-exam years or after significant change in health status. Only those examinees certifying a change in health status or submitting additional information will require review and must be reconciled with the examinee. The contractor will make the appropriate qualification and printable certificate will be made available for qualified personnel.

1. Approximately 50 examinee profiles with limited electronic health records consisting of previous qualification information, exam and qualification dates, and risk mitigation/waiver will be transferred. The Contractor must upload this information into the system of record and establish a seamless transition that aligns previous periodicity and qualification status, including previous waivers with future qualification determinations.

1. There will be up to 5 TCMSP ordering officials. A list of currently known ordering officials and associated unit identifiers will be provided upon award.

1. RMO Orientation & Refreshers – The Bureau of Land Management Communications Tower Climbing Program will provide RMO Orientation and subsequent refreshers, in coordination with other programs where possible.

PWS Attachment A Program Specific Supplement 4:

National Park Service (NPS) Law Enforcement

Background The NPS currently employs approximately 1,900 primary duty law enforcement park (protection) rangers and approximately 60 special agents (criminal investigators) on staff who promote safety, security, and resource protection of NPS lands, visitors, and employees. Collateral duties may include the following: firearms instructor, wildland firefighter, structural firefighter and/or scuba diver.

To fulfill the NPSs mission, which purpose is to conserve the scenery, natural and historic objects and wildlife in the NPS units, law enforcement rangers and special agents ensure these areas are free of criminal activity that threatens or compromises the ecological health and integrity of protected national and cultural resources and/or disrupts an atmosphere conducive to public safely and enjoyment.

The objectives of the NPS Law Enforcement program are: (1) the detection and investigation of criminal activity and the apprehension and successful prosecution of criminal violators, and (2) the prevention of criminal activities through resource education, public safety efforts and deterrence.

NPSs primary duty of commissioned employees is to meet the objective of the law enforcement program by detecting and investigating offenses against the Unites States, apprehending, and detailing those suspected of such offenses.

The NPS requires that its law enforcement personnel meet suitability (i.e. medical standards) requirements, satisfy special and continuing training requirements, participate in physically and emotionally demanding activities, carry firearms and other defensive equipment, and make instantaneous decisions pertaining to the appropriate use of varying levels of force, including deadly force, in the performance of their duties.

Data & Health Record Management

Notification of periodicity expirations shall be made as follows:

1. Examinee shall be notified at 60 days and at 30 days prior to the expiration (three years from exam date) of their most recent exam.

Medical Exams and Clearances

0. Medical exams are required as stated in PWS Technical Appendix 2 with the following adjustments:

0. With every Comprehensive Exam, the following should be added:

0. Chest X-Ray (scuba divers only)

0. With every Periodic Exam every three (3) years, the following should be added:

1. Labs for blood lead and ZPP (firearms instructors only).

1. Chest X-Ray (scuba divers only).

0. Periodicity

1. Comprehensive exam - required for initial/baseline exam only. Also offered (optional) to retiring employees.

1. Periodic exam - every three years

1. Blood lead, ZPP labs, and audiogram are offered annually upon request for Firearms Instructors only.

0. Additional Qualification Determinations which may be requested, dependent on employee/applicants’ collateral duty requirements:

2. Wildland Firefighter Determination- additional qualification to fulfill arduous Wildland Firefighters medical requirement under the Federal Interagency Wildland Firefighter Medical Qualification Standards Program.

2. Scuba Diver Determination- the additional chest x-ray result associated with this clearance request is within normal limits.

2. OSHA Respirator Determination

2. Firearms Instructor Determination – the additional labs and audiogram results associated with this request are within normal limits.

Medical Review & Qualification Determinations

LAW ENFORCEMENT DUTY: Upon review of exam against the NPS Law Enforcement Medical Qualification Standards, RMO shall make one of the following qualification determinations:

Medically Qualified: Designation by a licensed medical professional an individual meets or exceeds all the interagency law enforcement medical standards established to perform the essential functions of the law enforcement position:

Not Medically Qualified; the RMO will specify the following via report to the MSPM: a) standard(s) not met; b) whether the non-qualifying condition is static and stable; c) any recommendation on what additional medical documentation or other would be helpful should the employee/applicant appeal their determination.

Qualified with Waiver: Examinee does not meet one or more of the NPS Medical Standards, but through a waiver/appeal process, agency review and approval, the examinee has been qualified with:

1. Waiver - Waives requirement to meet a medical standard when there is sufficient evidence the law enforcement officer can perform the essential functions of the job safely and efficiently, without endangering the health and safety of the individual or others.

1. Risk Mitigation – Wildland Firefighter Clearance only

Contractor shall have a method to upload waiver (or risk mitigation for wildland fire) documents into the system. Upon receipt of the updated documents the contractor will update the system of record from “Not Medically Qualified” to “Qualified with Waiver Issued” or “Qualified with Waiver Renewed” (or “Qualified with Risk Mitigation” for Wildland Firefighter clearance only).

If additional information is needed for RMO to make a final determination of ‘medically qualified’ or ‘not medically qualified’:

1. Contractor will coordinate with the examinee to acquire this information. If all applicable medical information is obtained from the examinee’s personal physician and medical clearance is still not warranted (i.e. not medically qualified), the examinee may continue to submit more information for up to 90 days from the initial appointment date. If no information or insufficient information is submitted within 90 days, the contractor shall make a final determination with the available information at that time.

1. Review of any additional information submitted by the examinee within the 90-day time frame will be considered part of the initial NPS LE determination. This determination is listed separately in the pricing schedule.

Self-certification Determinations The NPS Law Enforcement Program will not require self-certification determinations.

Rural/Remote Locations and Mobile Unit Deployment The NPS Law Enforcement Program will not require mobile events.

There will be up to 150 designated NPS Law Enforcement ordering officials, including one (1) MSPM with highest access. A list of currently known ordering officials and associated unit identifiers will be provided upon award.

image1.png image2.png image3.png image4.jpeg image5.png image6.jpeg image7.jpeg