EXHIBIT_A_-_SCOPE_OF_WORK_(Updated_per_Addendum_2).pdf

EXHIBIT A

SCOPE OF WORK

1. OBJECTIVES:

The objective of the Phoenix Fire Department Health and Wellness Center (PFDHWC) is to provide occupational medicine health services and electronic health records management for sworn staff from both the City of Phoenix (City) Fire and Police Departments as well as public safety personnel assigned to other jurisdictions throughout the region who have contracted with PFDHWC for these services. Firefighting is an unpredictable and dangerous profession that requires significant physical demands, leaving firefighters at great risk for injury and illness.

It is the goal of the PFDHWC to support firefighters in maximizing performance while minimizing risk for injury and illness. It is the priority of PFDHWC to provide skilled, efficient and thorough medical management with superior customer service through teamwork. The Contractor is expected to treat sworn members as tactical athletes. A Tactical Athlete is defined as someone who uses a combination of physical fitness, mental resilience, and technical skills to perform their duties effectively and in dynamic high-stress environments.

To meet the objectives of the PFDHWC, the Contractor must be familiar with the entire scope of this Agreement, the services, and any conditions that may affect Contractor’s performance under this Agreement. Contractor must be fully experienced and properly qualified, in compliance with all applicable licensing requirements, and equipped, organized, and financed to perform such services.

Since 2012 the Phoenix Fire Department Physical Therapy Clinic (PFDPTC) has provided physical therapy assessment and treatment for industrial and non-industrial injuries, fitness assessments and injury prevention education for the providers at the PFDHWC that is within the scope of practice.

Contractor’s staff working in the PFDHWC are responsible for treating firefighters with minor injuries and will refer those with more serious injuries to appropriate medical and/or occupational specialists. The PFDHWC implements a physical exam schedule based on which member is filling the truck assignments on the day the truck is scheduled for their physical exam. The PFDHWC also has recheck (follow up) schedule for those members who are off the truck and accepts walk-in new injuries and members who have a release to return to work. Contractor’s staff will be assigned to the firefighter and that injury, and will follow PFD Management Procedures (Volume I Management Procedures) 103.02E, 103.06, and 104.02B until the injured worker has reached Medical Maximum Improvement (MMI), or is cleared for full duty by the specialist and the PFDHWC contracted provider. If a PFD member walks in for a recheck without an appointment, they will have the option to wait for a contracted provider to become available or can see first available provider.

Contractor’s staff will review physical exam testing results with the members and make appropriate recommendations. Contractor’s staff will assess, treat and/or refer as appropriate for treatment of work injuries. Provider will educate and counsel members with infectious disease and toxicological exposures, during initial https://www.phoenix.gov/administration/departments/fire/policies-procedures.html#accordion-868f671eaf-item-22288dce9f consultation and at follow up. Mental health counseling as well as member support is available utilizing the mental health resources set in place by the City and the Fire Department’s Employee Assistance Program. Additionally, Contractor will provide Department of Transportation (DOT) physicals for PFD members that require a DOT license who are on the Urban Search and Rescue (USAR) Task Force team as well as USAR Task Force clearance and screening for deployment.

Positive findings from physical/medical exams and work injuries may require specialist evaluations, treatment, surgery, rehabilitation and return to work appointments. The PFDHWC likes to have many resources for the members to choose from. The Contractor shall offer the ability to provide contact information for direct, expedited access to care through their provider network to specialty providers. These providers will need to accept the Workers’ Compensation, Industrial Commission of Arizona fee schedule, and/or be in network with all City current medical health insurance plans (City of Phoenix Human Resources). The PFDHWC is not required to treat/prescribe for non-work-related injuries or illness.

The contracted staff identify positive findings, make recommendations/referrals.

Follow up to ensure treatment was received and monitor work status for safety issues.

Services provided by Contractor will be performed in a manner consistent with the highest level of care and skill ordinarily exercised by members of Contractor’s profession currently practicing in the same role under similar conditions.

2. FACILITY OVERVIEW, SERVICES AND MISCELLANEOUS REQUIREMENTS:

2.1. CITY STAFF:

A Phoenix Fire Department Deputy Chief has overall management authority over the PFDHWC. In addition to the Deputy Chief, the PFDHWC has two permanent staff: one Administrative Aide and one Administrative Assistant I/Clinic Operations Manager.

2.2. FACILITY:

The PFDHWC is operated out of approximately 13,000 square feet of space.

The facility includes five examination rooms as well as specialized testing rooms. Current major medical equipment includes multiple spirometers for testing lung capacity, a hearing test booth, multiple vision testing machines, digital X-ray machine, multiple treadmills with stress test equipment, a VO2 bicycle, a blood centrifuge, and electrocardiogram (EKG) machines which are all maintained by an outside vendor contracted with the PFDHWC. Space also includes a rehabilitation gym that includes functional strength and cardiovascular equipment with physical therapy treatment tables and modalities. The contracts for equipment maintenance, medical laboratory testing, and the radiology reads are independent of this staffing contract for the PFDHWC.

https://www.fmcsa.dot.gov/medical/driver-medical-requirements/dot-medical-exam-and-commercial-motor-vehicle-certification https://www.azica.gov/ https://www.phoenix.gov/administration/departments/hr.html

2.3. LOCATION AND HOURS OF OPERATION:

2.3.1. Location Requirements:

Services will take place and Contractor’s staff will report to the PFDHWC currently located at 150 S. 12th St., Phoenix, AZ 85034.

A. Remote work by certain positions, such as Cardiologists, may be approved in advance by the PFDHWC Deputy Chief. Contractor’s staff schedules will be coordinated between Contractor and PFDHWC staff, to ensure minimum staffing aligns with the patient appointment schedule.

B. Contractor’s staff are required to be on-site in accordance with

Facility and/or clinic hours, unless mutually agreed upon by City and Contractor, to ensure Contractor’s staffing meets clinic schedules and PFDHWC operations. All hours and schedules are subject to change depending on PFDHWC needs

2.3.2. PFDHWC Hours:

Facility hours are 7:30 a.m. to 4:00 p.m. Monday through Friday.

PFDHWC Clinic hours are 7:30 a.m. to 12:00 p.m. and 12:30 p.m. to 4:00 p.m. Monday through Friday, with a 30-minute lunch period.

2.3.3. Physical Therapy Clinic Hours:

Physical Therapy (PT) Clinic hours are 6:00 a.m. to 2:30 p.m., Monday through Friday, with a 30-minute lunch period that may vary in time of day, due to patient scheduling.

2.3.4. Staff Meetings:

Monthly staff meetings and staff training are scheduled during the hour of 11:30 a.m. to 12:30 p.m. Staff will be permitted to flex 30 minutes during the same work week, as mutually agreed upon by Contractor and City. Contractor’s staff on duty will attend these scheduled meetings, unless mutually agreed upon by Contractor and City.

2.3.5. After-Hours Call Rotation Requirements

Contractor’s full-time providers assigned to work under this Contract and assigned to the PFDHWC are required to provide after-hours call rotation services, to respond to firefighter injury notifications, act as a liaison between the PFD member and emergency room care staff, and answer calls 24/7 during their scheduled rotation time. Contractor shall provide the PFDHWC with the finalized on-call rotation schedule of no less than 60 days in advance.

2.3.6. Holiday Closures:

The PFDHWC is closed on all City of Phoenix observed holidays.

2.4. INDUSTRIAL INJURY PROGRAM:

The PFDHWC provides in-house evaluation and treatment of industrial injuries. Through this program, PFD members who are injured on the job https://www.phoenix.gov/calendar/holidays.html report to the PFDHWC for evaluation. The Contractor’s staff is responsible for treating firefighters with minor injuries and refers those with more serious injuries to appropriate medical and/or occupational specialists. The contracted staff will be responsible for the coordination of care and case management for these injuries.

2.5. PHYSICAL EXAMINATION SERVICES:

The physical examination performed by the PFD is comprehensive and follows the NFPA 1580 Standard for Emergency Responder Occupational Health and Wellness, current edition guidelines. Any further lab tests that are recommended by the NFPA or considered standard medical care for professional firefighters may be added to our current blood panel. The physical examination currently includes the following elements:

A. Annual Patient Health Review B. Blood testing and analysis consisting of: Chem 18/HDL/Lipid

Panel/CBC/TSH, Uric Acid/Micro/ HbA1c - (New Hires/New Patients and Annually for all firefighters)

C. Hepatitis-B Antibodies – (New Hires/New Patients only) D. Hepatitis-C Antibodies – (New Hires/New Patients only) E. Prostate Specific Antigen (PSA) - (New Hires and Annually for Males age 40 and older only) F. Varicella Titer – (New Hires/New Patients only) G. Hearing Conservation Program - Hearing Testing and Evaluation

(assessed in an American National Standards Institute (ANSI)-approved soundproof audiometric booth)

H. Visual Acuity Testing and Evaluation I. Vital Signs (temperature, pulse and respiratory rate, and blood pressure) J. Spirometry/Pulmonary Function Test and Evaluation K. EKG Stress Test (treadmill/bike)

(New Hire Firefighter Recruits perform a MAX Treadmill; a Sub-max is performed annually thereafter unless otherwise determined by a Health and Wellness Center Clinician. Non-Sworn New Hires perform resting EKG only)

L. C-PET on members selected by Medical Director for diagnostics of varying pathologies.

M. Chest X-Ray (New Hires and every four years thereafter, unless Health and Wellness Center Clinician deem it necessary)

N. InBody-Bioelectrical Impedance Equipment or skin fold measurement by calipers, body weight and height

O. Immunization history screening and review P. Consultation with provider to discuss physical examination.

2.6. EXPEDITED SPECIALISTS’ EVALUATIONS:

2.6.1. Positive findings from physical/medical exams and work injuries may require specialist evaluations, treatment, surgery, rehabilitation and return to work appointments. The PFDHWC likes to have many resources for the members to choose from. The Contractor shall https://www.nfpa.org/codes-and-standards/nfpa-1580-standard-development/1580 provide a list of specialists who can offer direct, expedited access ensuring Firefighters can be evaluated within 2 business days. These specialists must be within the Contractor’s network or have an established business relationship with the Contractor. These providers will need to accept the Workers’ Compensation, Industrial Commission of Arizona fee schedule for industrial Injury referrals and/or be in network with all City current medical health insurance plans (City of Phoenix Human Resources) for recommendations/referrals generated from physical exams or medical consultations. The PFDHWC is not required to treat/prescribe for non-work-related injuries or illness.

Contractor shall identify positive findings, make recommendations/referrals, and provide follow-up to ensure treatment was received and monitor work status for safety issues.

2.6.2. Expedited Access is Required to Specialists in the Following Areas: Addiction Medicine, Cardiology, Chiropractor, Dermatology, Digestive Health, Ear Nose and Throat, Endocrinology, Family Medicine, Hand Surgery, Hematology, Infectious Disease, Oncology, Ophthalmology, Orthopedic, Otolaryngology, Neurology, Pain Management, Physiatry, Plastic Surgery, Podiatry, Physical Medicine, Pulmonology, Sleep Specialist, Spine Surgeon, Toxicology, Urology/Trauma Urology, Vascular, Wound Care.

2.6.3. Expedited Access is Preferred in the Following Areas: Imaging to include CT, MRI, and Ultrasound, Physical Therapy and Rehabilitation.

Note: For industrial injuries, imaging must be scheduled through the City of Phoenix or the Third-Party Administrator’s contracted vendor.

2.7. PHYSICAL THERAPY SERVICES:

The PFDHWC provides in-house physical therapy to assist in the evaluation and treatment of industrial injuries, injury prevention, and overall wellness.

Through this program, PFD members who are injured will receive physical therapy evaluation and treatment at the PFD member’s request and in accordance with Contractor’s recommendations. All injured members will have one evaluation in PFDPT to get treatment started immediately.

2.8. RESEARCH ENGAGEMENT:

As the 5th largest fire department in the United States, fire departments throughout the nation as well as the NFPA and IAFF look to the PFD’s best practices for various current medical and treatment concerns. The PFD is often asked to engage in both large- and small-scale research programs and at times present this information at fire service conferences. The ability to engage in, share resources and support the Contractor’s Medical Director and PFD with various evidence based, peer reviewed research is expected from the Contractor. This will include but is not limited to research in the following areas: Medical conditions and concerns in the fire service (both nationally and locally), preventative and post exposure policies to support the safety of firefighters and best practices.

The research the PFD commits to engage in will be determined by the PFD https://www.azica.gov/ https://www.azica.gov/ based on expense and/or membership support and must be supported by Contractor’s professional medical staff.

2.9. ANNUAL SERVICES AVERAGES:

The annual average services provided at the PFDHWC are as follows:

A. Average Annual Physicals: 2,500 B. Average Retiree Physicals: 100 C. Average Pre-Placement Physicals: 200 D. Average Industrial Injury Evaluations: 4,400 E. Average Non-Industrial Evaluations: 500 F. Average Immunizations and Lab draw combined: 500 G. Average Post Exposure Consultations: 75 H. Average Physical Therapy visits: 3,850

2.10. POINTS OF CONTACT:

Contractor will provide a designated contact person for the PFDHWC Deputy Chief to address concerns with Contractor’s staffing and/or services. This designee will be appointed by the Contractor and must be able to make decisions and resolve issues regarding the services and Contractor’s staff management. Contractor’s designee should be generally available by phone as well as in person and on-site to meet with PFDHWC Deputy Chief for meetings as needed.

The PFDHWC Program Manager/Contract Monitor for PFD is the PFDHWC Deputy Chief, who is currently located at 150 S. 12th St., Phoenix, AZ 85034.

2.11. TRAUMA AND TOXICOLOGY:

Affiliation with a Level 1 Trauma Facility in the Phoenix metropolitan area with access to toxicology referral within one hour of PFD request is required.

2.12. BUSINESS TRAVEL REIMBURSEMENT:

Contractor’s staff may be requested to represent PFD at National Fire Protection Association or fire service meetings and/or conferences related to firefighter health and safety. The PFDHWC Deputy Chief must approve all travel and attendance in advance. To ensure the clinic remains appropriately staffed, business travel requests must be presented to the PFDHWC Chief no later than 90 days prior to the travel departure date. Contractor’s travel expenses shall not exceed $5,000.00 per fiscal year. Contractor will submit an invoice for reimbursement of travel expenses within the corresponding month, and in accordance with the City’s current travel policies and the Internal Revenue Service’s authorized business mileage rate.

3. STAFFING REQUIREMENTS:

3.1. STAFFING (MEDICAL AND ADMINISTRATIVE SUPPORT STAFF):

3.1.1. Contractor must provide the staff listed below in the tables of Required

Staffing Positions and As Needed Staffing Positions. Staff must meet the qualifications described for each position, at the time of contract award. Consideration of incumbent staff who are trained, qualified and who occupy key roles would be beneficial to both parties for business operations and patient continuity of care.

3.1.2. Contractor’s staff must have completed and passed a background check in accordance with the Agreement, Section 2, and must include fingerprinting, prior to starting employment at PFDHWC.

3.1.3. Any positions requiring Continuing Education Units (CEUs) and certifications must be kept current.

3.1.4. Contractor nor Contractor’s staff must not be indicated on the Office of Inspector General’s (OIG) List of Excluded Individuals/Entities (LEIE) during the life of the Agreement.

3.1.5. All staff must have a working knowledge of an electronic health records management system.

3.1.6. All contracted staff are required to adhere to Phoenix Fire Department policies (Policies and Procedures | City of Phoenix), including the City’s Administrative Policies and PFD Volume I Management Policies which will be shared by the Contractor, with all staff who work under this contract.

3.1.7. Contractor shall ensure all required positions are filled, unless approved by the City. Failure to fill the required position may be considered a material breach of the contract.

3.1.8. Contractor shall provide resumes for Contractor’s staff assigned to work at the PFDHWC, to support the qualifications, responsibilities, and salary requested.

3.1.9. Table of Required Staffing Positions:

Estimated Quantity Position

Estimated Annual Hours

1 Medical Doctor - Director 2080 1 Medical Doctor - Physician - option for shared part-time (20hr/week) 2080

4 Physician Assistant – Certified (PA-C) 2080 1 Nurse Practitioner (APRN) 2080 1 Licensed Behavioral Health Specialist 2080 1 Registered Nurse - Office Supervisor 2080 1 Registered Nurse - Treadmill Nurse 2080 1 Registered Nurse - RN Case Manager 2080 2 Licensed, Certified Radiology Technician 2080 2 Medical Assistant 2080 1 Case Management Coordinator 2080 https://exclusions.oig.hhs.gov/?AspxAutoDetectCookieSupport=1 https://www.phoenix.gov/administration/departments/fire/policies-procedures.html https://www.phoenix.gov/administration/departments/fire/policies-procedures.html#accordion-868f671eaf-item-22288dce9f

Estimated Quantity Position

Estimated Annual Hours

1 Medical Records Specialist/Receptionist 2080 1 Scheduling Coordinator/Receptionist 2080 1 Patient Liaison 2080 1 Director of Rehabilitation Services (Licensed

P.T.) 2080

2 Licensed Physical Therapist 2080 2 Licensed, Certified Athletic Trainer 2080 2 Licensed Physical Therapy Assistant 2080 2 Rehabilitation Technician 2080 1 Licensed Massage Therapist 2080 1 Certified Strength and Conditioning Coach 2080 1 Medical Biller 1248

3.1.10. As-Needed Positions (Per Diem)

The PFDHWC may require certain position to backfill contracted staffing positions on an as needed (per diem) basis, which are in addition to the positions listed in Section 3.1.9. Table of Staffing Positions.

Estimated Quantity As Needed Positions (Per Diem) Estimated

Annual Hours 2 Physician Assistant – Certified (PA-C) 384 1 Nurse Practitioner (APRN) 196 1 Licensed Physical Therapist 120-170 2 Board Certified Cardiologist 416 1 Board Certified Dermatologist 48

3.1.11. Responsibilities listed for each position are not all inclusive, and other duties may be assigned per PFDHWC needs.

3.1.12. Contractor’s staff will not perform any work unrelated to this Contract during the performance of Services. All Services performed must be directly related to this Contract.

3.2. QUALIFICATIONS AND RESPONSIBILITIES BY POSITION:

3.2.1. MEDICAL DOCTOR - DIRECTOR

Performs baseline physicals, evaluates, treats, and follows up on industrial injuries, infectious and hazardous material exposures.

Implements and supports an ongoing wellness program for fire department personnel and may be required to also perform DOT and Public Safety Dive Team hyperbaric examinations.

3.2.1.1. Responsibilities:

A. Serve as Contractor’s main point of contact with PFDHWC

Management to coordinate clinic schedules, discuss Contractor’s staff concerns, and other issues as needed.

B. Perform physical exams with an evaluation of testing: visual, audiometric, pulmonary function, body composition, blood and urine lab assessment, and stress treadmill or a C-PET VO2 to assess fitness for duty for firefighters in accordance with NFPA 1580 and 1582 (NFPA 1580 Standard for Emergency Responder Occupational Health and NFPA 1582 Standard on Comprehensive Occupational Medical Program).

C. Perform pre-placement physicals for firefighter applicants in accordance with NFPA 1580/1582.

D. Evaluate and treat work-related injuries of firefighters, perform diagnostic and therapeutic procedures, prescribe and monitor treatment including physical therapy, and refer to medical specialists.

E. Formulate diagnostic recommendations, develop, and implement treatment plans, monitor effectiveness of therapeutic interventions, prescribe appropriate medications, make appropriate referrals.

Ensure Fire’s follow up procedures are part of the treatment plan:

PFD Volume I Management Procedures (103.02E, 103.06, and 104.02B until the injured worker has reached Medical Maximum Improvement (MMI) or is cleared for full duty by the specialist and the PFDHWC contracted provider.

F. Perform consultations for firefighters with toxicologic or infectious exposure to HIV, Hepatitis C and B, tuberculosis, and others.

G. Create and revise current procedures at the PFDHWC regarding medical monitoring, fitness maintenance, and stress management.

H. Participate in and designate other providers to assist with research projects in firefighter health and wellness.

I. Prepare and present educational materials to firefighters at annual firefighter conferences as requested.

J. May be required to assist with pre-deployment medical exams for Federal Emergency Management Agency/Urban Search and Rescue (FEMA/US&R) Team, Arizona Task Force 1 (AZ-TF1) at the time of active deployment and participate in mobilization drills scheduled by the Phoenix Fire Department’s Special Operations section.

K. Act as AZ-TF1 Liaison while members are deployed.

L. Respond to firefighter injury notifications. Triage and determine work status advising Firefighter to report to nearest emergency room or the HWC the next business day. Act as a liaison between the PFD member and emergency room care staff, and answer calls 24/7 during their scheduled rotation time.

3.2.1.2. Minimum Qualifications:

A. Current Medical Doctor (MD) or Doctor of Osteopathic Medicine

(DO) license in the State of Arizona B. Ten years of experience in Occupational Health Medicine and/or

Emergency Medicine or Sports Medicine.

C. Current Drug Enforcement Administration (DEA) number.

https://www.nfpa.org/codes-and-standards/nfpa-1580-standard-development/1580 https://www.nfpa.org/codes-and-standards/nfpa-1580-standard-development/1580 https://www.nfpa.org/search?view=dynamic&rn=08185581835633915&sh=dynamic&globalsearch=true#q=nfpa%201582&aq=%40culture%3d%22en%22 https://www.nfpa.org/search?view=dynamic&rn=08185581835633915&sh=dynamic&globalsearch=true#q=nfpa%201582&aq=%40culture%3d%22en%22 https://www.deadiversion.usdoj.gov/

D. Current Advanced Cardiovascular Life Support (ACLS) certification or Board-Certified Emergency Medicine.

E. Current National Registry of Certified Medical Examiners (NRCME) (DOT) certification, or ability to become certified within 90 days of hire by Contractor to work at PFDHWC.

F. Working knowledge of and experience with the IAFF/IAFC Wellness Fitness Initiative, NFPA 1582 and OSHA 1910 (1910 | Occupational Safety and Health Administration) relating to firefighters.

3.2.1.3. Preferred Qualifications:

A. One year of experience of working with Scuba divers or involved in research, teaching, and/or patient treatment related to Hyperbaric Services

B. One year of experience working with the (USAR) Urban Search and Rescue team and have participated in deployment.

C. Emergency Medical Services (EMS) experience.

D. One year of experience with tactical athletes in a first responder environment.

3.2.2. MEDICAL DOCTOR - PHYSICIAN

Performs baseline physicals, evaluates, treats, and follows up on industrial injuries, infectious and hazardous material exposures.

Implements and supports an ongoing wellness program for fire department sworn personnel and may be required to perform DOT examinations.

3.2.2.1. Responsibilities:

A. Perform physical exams with an evaluation of testing: visual, audiometric, pulmonary function, body composition, blood and urine lab assessment, and stress treadmill or a C-PET VO2 to assess fitness for duty for firefighters in accordance with NFPA 1580 and 1582.

B. Perform pre-placement physicals for firefighter applicants in accordance with NFPA 1580 and 1582.

C. Evaluate and treat work-related injuries of firefighters, perform diagnostic and therapeutic procedures, prescribe and monitor treatment including physical therapy, and refer to medical specialists.

D. Formulate diagnostic recommendations, develop, and implement treatment plans, monitor effectiveness of therapeutic interventions, prescribe appropriate medications, make appropriate referrals.

Ensure Fire’s follow up procedures are part of the treatment plan:

PFD Volume I Management Procedures 103.02E, 103.06, and 104.02B until the injured worker has reached Medical Maximum Improvement (MMI) or is cleared for full duty by the specialist and the PFDHWC contracted provider.

E. Perform consultations for firefighters with toxicologic or infectious exposure to HIV, Hepatitis C and B, tuberculosis, and others.

https://nationalregistry.fmcsa.dot.gov/home https://www.osha.gov/laws-regs/regulations/standardnumber/1910 https://www.osha.gov/laws-regs/regulations/standardnumber/1910

F. Develop, update and revise procedures at the PFDHWC regarding medical monitoring, fitness maintenance, and stress management.

G. Participate in research projects in firefighter health and wellness as requested.

H. Prepare and present educational materials to firefighters at annual firefighter conferences as requested.

I. May be required to assist with pre-deployment medical exams for FEMA/US&R Team, AZ-TF1 at the time of active deployment and participate in mobilization drills scheduled by the Phoenix Fire Department’s Special Operations section.

J. Fulltime Doctor (not a shared position) will respond to firefighter injury notifications. Triage and determine work status advising Firefighter to report to nearest emergency room or the HWC the next business day. Act as a liaison between the PFD member and emergency room care staff, and answer calls 24/7 during their scheduled rotation time.

3.2.2.2. Minimum Qualifications:

A. Current M.D or D.O. license in the State of Arizona B. Current DEA number.

C. Current ACLS certification or Board-Certified Emergency Medicine.

D. Current NRCME (DOT) certification, or ability to become certified within 90 days of hire by Contractor to work at PFDHWC.

E. Five years of experience in Occupational Health Medicine and/or

Emergency Medicine or Sports Medicine.

3.2.2.3. Preferred Qualifications:

A. One year of experience working with Scuba divers or involved in research, teaching, and/or patient treatment.

B. One year of experience working with (USAR) Urban Search and

Rescue Team.

C. One year of EMS experience.

D. One year of experience working with the IAFF/IAFC Wellness

Fitness Initiative, NFPA 1582 and OSHA 1910 relating to firefighters.

E. One year of experience with tactical athletes in a first responder environment.

3.2.3. PHYSICIAN’S ASSISTANT - CERTIFIED (PA-C)

Performs baseline physicals, evaluates, treats, and follows up on industrial injuries, infectious and hazardous material exposures.

Implements and supports an ongoing wellness program for fire department sworn personnel and may be required to perform DOT examinations.

3.2.3.1. Responsibilities:

A. Perform physical exams with an evaluation of testing: visual, audiometric, pulmonary function, body composition, blood and urine lab assessment, and stress treadmill or a C-PET VO2 to https://www.iaff.org/wellness-fitness/ assess fitness for duty for firefighters in accordance with NFPA 1580/1582.

B. Perform pre-placement physicals for firefighter applicants in accordance with NFPA 1580 and 1582.

C. Evaluate and treat work-related injuries of firefighters, perform diagnostic and therapeutic procedures, prescribe and monitor treatment including physical therapy, and refer to medical specialists.

D. Formulate diagnostic recommendations, develop, and implement treatment plans, monitor effectiveness of therapeutic interventions, prescribe appropriate medications, make appropriate referrals.

Ensure Fire’s follow up procedures are part of the treatment plan:

PFD Volume I Management Procedures (Volume I Management Procedures) 103.02E, 103.06, and 104.02B until the injured worker has reached Medical Maximum Improvement (MMI) or is cleared for full duty by the specialist and the PFDHWC contracted provider.

E. Perform consultations for firefighters with toxicologic or infectious exposure to HIV, Hepatitis C and B, tuberculosis, and others.

F. Develop, update and revise procedures at the PFDHWC regarding medical monitoring, fitness maintenance, and stress management.

G. Develop, manage, track, and report the outcomes of research projects in firefighter medicine.

H. Prepare and present educational material to firefighters.

I. Support/develop wellness programs to reduce injuries and illness within the firefighting community.

J. Only full-time (not per diem) contracted staff are required to respond to firefighter injury notifications. Triage and determine the work status of the firefighter, and advise to report to nearest emergency room, or the PFDHWC the next business day. Act as a liaison between the PFD members and emergency room care staff, and answer calls 24/7 during their scheduled rotation time.

3.2.3.2. Minimum Qualifications:

A. Must be nationally certified through the National Commission on

Certification of Physician Assistants (NCCPA).

B. Current license in the State of Arizona.

C. Five years of experience in Occupational Health Medicine and/or

Family Practice and/or Sports Medicine/Orthopedic Medicine.

D. Current DEA number.

E. Current ACLS certification.

F. Current NRCME (DOT) certification, or ability to become certified within 90 days of hire by Contractor to work at PFDHWC.

3.2.3.3. Preferred Qualifications:

research, teaching, and/or patient treatment.

B. One year of EMS experience C. One year of experience working with the IAFF/IAFC Wellness

Fitness Initiative, NFPA 1582 and OSHA 1910 relating to firefighters.

https://www.phoenix.gov/administration/departments/fire/policies-procedures.html#accordion-868f671eaf-item-22288dce9f https://www.phoenix.gov/administration/departments/fire/policies-procedures.html#accordion-868f671eaf-item-22288dce9f https://www.nccpa.net/ https://www.nccpa.net/

D. One year of experience working with tactical athletes in a first responder environment.

3.2.4. NURSE PRACTITIONER (APRN)

Performs baseline physicals, evaluates, treats, and follows up on industrial injuries, infectious and hazardous material exposures. Implements and supports an ongoing wellness program for fire department sworn personnel and may be required to perform DOT examinations.

3.2.4.1. Responsibilities:

A. Perform physical exams with an evaluation of testing: visual, audiometric, pulmonary function, body composition, blood and urine lab assessment, and stress treadmill or a C-PET VO2 to assess fitness for duty for firefighters in accordance with NFPA 1580 and1582.

B. Evaluate and treat work-related injuries of firefighters, perform diagnostic and therapeutic procedures, prescribe and monitor treatment including physical therapy, and refer to medical specialists.

C. Formulate diagnostic recommendations, develop, and implement treatment plans, monitor effectiveness of therapeutic interventions, prescribe appropriate medications, make appropriate referrals.

Ensure Fire’s follow up procedures are part of the treatment plan:

PFD Volume I Management Procedures 103.02E, 103.06, and 104.02B until the injured worker has reached Medical Maximum Improvement (MMI) or is cleared for full duty by the specialist and the PFDHWC contracted provider.

D. Perform pre-placement physicals for firefighter applicants in accordance with NFPA 1580 and 1582.

E. Perform consultations for firefighters with toxicologic or infectious exposure to HIV, Hepatitis C and B, tuberculosis, and others.

F. Develop, update and revise procedures at the PFDHWC regarding medical monitoring, fitness maintenance, and stress management.

G. Develop, manage, track, and report the outcomes of research projects in firefighter medicine.

H. Prepare and present educational material to firefighters.

I. Support/develop wellness programs to reduce injuries and illness within the firefighting community.

J. Only full-time (not per diem) contracted staff are required to respond to firefighter injury notifications. Triage and determine the work status of the firefighter, and advise to report to nearest emergency room, or the PFDHWC the next business day. Act as a liaison between the PFD member and emergency room care staff, and answer calls 24/7 during their scheduled rotation time.

3.2.4.2. Minimum Qualifications:

A. Current Registered Nurse license and Advanced Practice

Registered Nurse (APRN) license in the State of Arizona.

B. Five years of experience in Occupational Health Medicine and/or

Family Practice and/or Sports Medicine/Orthopedic Medicine.

C. Current DEA number.

D. Current (ACLS) Advanced Cardiovascular Life Support certification.

E. Current NRCME (DOT) certification, or ability to become certified within 90 days of hire by Contractor to work at PFDHWC.

3.2.4.3. Preferred Qualifications:

research, teaching, and/or patient treatment.

B. One year of EMS experience.

C. One year of experience working with the IAFF/IAFC Wellness

Fitness Initiative, NFPA 1582 and OSHA 1910 relating to firefighters.

D. One year of experience working with tactical athletes in a first responder environment.

3.2.5. LICENSED BEHAVIORAL HEALTH SPECIALIST

3.2.5.1. Responsibilities:

A. Aid and coordinate psychological services to all Fire Department sworn members.

B. Responsible for members who are utilizing the Traumatic Event

Counseling (TEC) benefit and off the truck, require 30-day follow-up and work status check.

C. Manage employees’ treatment and work status who have been remanded by Fire Human Resources.

D. Standby, callout, and off campus responsibilities as needed.

E. Instructor for fire academy to educate new members on PFDHWC mental health purpose.

F. Responsible for any projects or research deemed necessary.

G. Coordinate time off and return to work for the members off the truck and while utilizing the TEC benefit with PFD Staff in the HWC.

H. Consult with new PFD recruit candidates and incumbents who are participating in the PFD Re-Entry program as needed.

I. Works closely with PFD Member Services and the contracted

Employee Assistance Program (EAP) to coordinate member’s treatment and time off from work.

3.2.5.2. Minimum Qualifications:

A. Five years of experience in behavioral health medicine.

B. Current M.D or D.O. license in the State of Arizona or

Current Registered Nurse license and Advanced Practice Registered Nurse (APRN) license in the State of Arizona.

C. Nationally certified through the National Commission on Certification of Physician Assistants (NCCPA).

D. Current DEA number.

3.2.5.3. Preferred Qualifications:

A. Working knowledge of and experience with the IAFF/IAFC

Wellness Fitness Initiative, NFPA 1582 and OSHA 1910 relating to firefighters.

https://www.iaff.org/wellness-fitness/ https://www.iaff.org/wellness-fitness/ https://www.phoenix.gov/administration/departments/hr/careers/benefits/benefits-active/additional-benefits-current-employees.html#accordion-4e15cbef51-item-8d1068981b https://www.nccpa.net/ https://www.nccpa.net/

B. Experience with tactical athletes in a first responder environment.

3.2.6. REGISTERED NURSE – OFFICE SUPERVISOR

3.2.6.1. Responsibilities:

A. Assists the PFDHWC Operations Manager and Medical Director with clinic operations, as needed.

B. Ensures smooth workflow and operations of the PFDHWC daily clinic.

C. Monitors the Contractor’s staff workload ratios to accomplish the most effective use of resources.

D. Discuss operational changes with the Medical Director before implementation.

E. Participate in:

i. Staff Selection and Orientation

ii. Staff development and education

iii. Performance Management

iv. Performs coaching, counseling & performance management.

Requires the ability to negotiate conflict.

F. Supports change and development, interpretation, implementation, and evaluation of the PFDHWC programs.

G. Demonstrates effective communication skills, problem solving, and conflict resolution by keeping the appropriate people informed.

H. Documents chief complaint and symptoms, performs vital signs, height, weight, visual screen, audiometry, spirometry, and the InBody. Reports any changes or concerns to provider.

I. Restocks and turn over exam rooms, assist the patient as well as inform the patient of exam procedures and ensure that safety and comfort measures are taken.

J. Obtains and organizes the patient’s medical record prior to the patient’s appointment.

K. Assists in monitoring daily schedules and facilitates smooth patient flow.

L. Answers telephone calls and provide the necessary information or take messages as necessary.

M. Draws blood for testing by laboratory.

N. Administers immunizations as required.

O. Assists with maintaining a clean, functional environment through regular cleaning of equipment, sterilizing medical instruments, cleaning exam rooms and storage area; notifies staff member regarding ordering supplies and assists with stocking supplies;

assists with restocking exam rooms; perform basic maintenance;

notifies support staff regarding any necessary repairs.

P. Follows manufacturer’s recommendations and OSHA guidelines in handling hazardous substances.

Q. Assumes responsibility for the proper collection of specimens, related paperwork, and delivery of specimens to the appropriate place.

R. Assists providers with physical exam acting as a third party in attendance.

S. Assists with special procedures as necessary.

T. Coordinates and participates in special projects as requested by

PFD.

3.2.6.2. Minimum Qualifications:

A. Registered Nurse in the State of Arizona.

B. Ten years of clinical nursing experience.

C. Five years of Occupational Health and/or Family Practice and/or

Emergency Room D. Current ACLS certification.

E. Current CAOHC and NIOSH certifications or acquired within 1 year of Contractor’s hire date to work at PFDHWC.

F. Must be able to use various personal computer software programs including, but not limited to, Outlook, electronic medical records system, Microsoft suite.

G. Must be detail oriented and able to multitask with excellent customer skills, verbal and written.

H. Ability to prioritize and handle a variety of tasks simultaneously, with frequent interruptions, and work independently.

3.2.6.3. Preferred Qualifications:

A. Bachelor of Science in Nursing from an accredited institution.

B. Working knowledge of and experience with the IAFF/IAFC

Wellness Fitness Initiative, NFPA 1582 and OSHA 1910 relating to

C. Experience with tactical athletes in a first responder environment.

3.2.7. REGISTERED NURSE - TREADMILL NURSE

3.2.7.1. Responsibilities:

A. Proficient in resting 12-Lead EKG’s, V02, C-PET and stress tests.

B. Schedule Paramedic to perform treadmill testing based on PFD supplied paramedic list in accordance with PFDHWC scheduling guidelines.

C. Co-Manage with PFD Clinic Operations Manager and the Medical Director-the PFD’s Tier 4 Health Assessment Program (EXHIBIT D) assuring consistency in follow-up appointments and that required medical documentation is provided to clinicians upon request.

D. Schedule make up treadmills utilizing the electronic health record and Telestaff.

E. Ensure that the scheduled PFD Paramedic checks that the PFDHWC drug box is locked, inventory is checked and logged daily using electronic patient care reporting on the PFD supplied iPad.

F. Perform daily treadmills monitoring patient heart rate reporting any issues to the provider.

G. Assist with the preparation of charts and the flow of patients as needed.

H. Perform back-office evaluations, vision, pulmonary function, hearing, and the InBody as needed.

I. Perform phlebotomy and administer medications as needed.

https://www.caohc.org/ https://www.cdc.gov/niosh/spirometry/training/index.html

J. Enter back-office evaluations into Electronic Medical Records system.

K. Assist clinicians with data collection for studies.

L. Assist clinicians with the treatment of medical and industrial patients.

M. Assist with maintenance and stocking of medications and medical supply inventory.

N. Assist with maintaining a clean, functional environment through regular cleaning of equipment, sterilizing medical instruments, cleaning exam rooms and storage area; notifies staff member regarding ordering supplies and assists with stocking supplies;

assists with restocking exam rooms; performs basic maintenance;

notifies support staff regarding any necessary repairs.

O. Follow manufacturer’s recommendations and OSHA guidelines in handling hazardous substances.

P. Responsible for the proper collection of specimens, related paperwork, and delivery of specimens to the appropriate place.

3.2.7.2. Minimum Qualifications:

B. Five years of clinical experience.

C. Current ACLS certification.

D. Current CAOHC and NIOSH certifications or acquired within one year of Contractor’s hire date to work at PFDHWC.

E. Two years of experience and knowledge in stress treadmill testing.

F. Must be able to use various personal computer software programs including, but not limited to, electronic medical records system, Outlook, and Microsoft Suite.

G. Ability to prioritize and handle a variety of tasks simultaneously, with frequent interruptions and able to work independently.

3.2.7.3. Preferred Qualifications:

B. V02 and/or C-PET testing experience C. Working knowledge of and experience with the IAFF/IAFC

Wellness Fitness Initiative, NFPA 1582 and OSHA 1910 relating to

D. Experience with tactical athletes in a first responder environment.

3.2.8. REGISTERED NURSE - RN CASE MANAGER

3.2.8.1. Responsibilities:

A. Must be detail oriented and able to multitask with excellent customer skills, verbal and written B. Tracks daily appointments, rescheduling no shows ensuring they are seen for their provider appointed follow-up.

C. Follows PFD Volume I Management Procedures 103.02E, 103.06, and 104.02B until the injured worker has reached Medical Maximum Improvement (MMI) or is cleared for full duty by the specialist and the PFDHWC contracted provider.

D. Ensuring accurate and up-to-date documentation of patient work statuses are on file for PFDHWC providers. Obtaining medical records needed.

E. Monitoring and evaluating patient progress and outcomes for members who are off on industrial leave or working a transitional work assignment.

F. Collaborate with PFDHWC providers and the physical therapist regarding patient care and concerns as needed.

G. Follow up with PFD members who are obtaining physical exam from outside the clinic. Ensuring all proper medical records/information is collected for PFDHWC provider to clear members for annual physical exam.

H. Advocating for the patient and ensuring their rights and preferences are respected utilizing medical knowledge to coordinate care and assessing the plan to return to work or remain off work.

I. Collaborate with healthcare teams, internally as well as externally (specialists, therapists, etc.).

J. Facilitates PFD members non-work-related referrals and treatment recommendations from providers due to positive findings identified during medical exams.

K. Cross check of the PFDHWC Daily Roll call with Telestaff for department staffing and appointment compliance.

L. Work directly with the Case Coordinator and Clinic Operations Manager to ensure patient treatment and protocols are being followed.

M. Cross covers the Case Coordinator when away from work.

Requesting authorizations, sending referrals, completing the City of Phoenix-Employers Report of Injury documentation, Industrial packet filing and sending the PFDHWC Daily Roll call once work statuses are updated.

N. Cross cover updating work status changes in Telestaff and PFDHWC Daily Roll call.

O. Cross cover patient scheduling, check in/out as needed.

3.2.8.2. Minimum Qualifications:

B. Ten years of Clinical Nursing experience.

C. Three years of Occupational Health and/or Family Practice and/or

Home Health Care.

D. Five years’ experience in case management.

E. Current ACLS certification.

F. Must be able to use various personal computer software programs including, but not limited to, electronic medical records system, Outlook, and Microsoft Suite.

with frequent interruptions.

3.2.8.3. Preferred Qualifications:

B. Knowledge of Industrial Commission of Arizona forms and claims filing process.

C. Working knowledge of and experience with the IAFF/IAFC Wellness Fitness Initiative, NFPA 1582 and OSHA 1910 relating to

D. Experience with tactical athletes in a first responder environment.

3.2.9. LICENSED CERTIFIED RADIOLOGY TECHNICIAN

3.2.9.1. Responsibilities:

A. Independently performs prescribed radiographic procedures and analysis for annual physical and industrial injuries.

B. Accountable for the ethical, legal, and professional responsibilities related to radiology practice. This includes maintaining confidentiality in all work information.

C. Monitors and maintains an adequate inventory of supplies and material to ensure non-interruption of services.

D. Prepares and maintains accurate documentation.

E. Responsible for the maintenance of all X-ray records.

F. Perform other duties to include but are not limited to documents chief complaint and symptoms, perform vital signs, height, weight, visual screen, audiometry, spirometry, and the InBody. Reports any changes of condition to RN or clinician.

G. Restocks and turn over exam rooms, assist the patient as well as inform the patient of exam procedures and ensure that safety and comfort measures are taken.

H. Obtains and organizes the patient’s medical record prior to the patient’s appointment.

I. Assists in monitoring daily schedules and facilitates smooth patient flow.

J. Answers telephone calls and provide the necessary information or take messages as necessary.

K. Draws blood for testing by laboratory.

L. Administers immunizations as required.

M. Assists with maintaining a clean, functional environment through regular cleaning of equipment, sterilizing medical instruments, cleaning exam rooms and storage area; notifies staff member regarding ordering supplies and assists with stocking supplies;

assists with restocking exam rooms; perform basic maintenance;

notifies support staff regarding any necessary repairs.

N. Follows manufacturer’s recommendations and OSHA guidelines in handling hazardous substances.

O. Assumes responsibility for the proper collection of specimens, related paperwork, and delivery of specimens to the appropriate place.

P. Assists provider with physical exam acting as a third party in

Q. Assists with special procedures as necessary.

3.2.9.2. Minimum Qualifications:

A. Licensed in the State of Arizona and certification from the American

Registry of Radiologic Technologists (ARRT).

B. Five years of X-Ray experience.

C. Three years of Occupational Health and/or Orthopedic and/or

Emergency Department experience.

D. Current CAOHC and NIOSH certifications or acquired within one year of Contractor’s hire date to work at PFDHWC.

E. Current Basic Life Support (BLS) certification.

3.2.9.3. Preferred Qualifications:

A. One year of experience working with the NFPA 1582 Standard on

Comprehensive Occupational Medical Program.

3.2.10. MEDICAL ASSISTANT

3.2.10.1. Responsibilities:

A. Document chief complaint and symptoms, perform vital signs, height, weight, visual screen, audiometry, spirometry, and the InBody. Reports any changes or concerns to RN or provider.

B. Restock and turn over exam rooms, assist the patient as well as inform the patient of exam procedures and ensure that safety and comfort measures are taken.

C. Obtain and organize the patient’s medical record prior to the patient’s appointment.

D. Assist in monitoring daily schedules and facilitate smooth patient flow.

E. Answer telephone calls and provide the necessary information or take messages as necessary.

F. Draw blood for testing by laboratory.

G. Administers immunizations as required.

H. Assist with maintaining a clean, functional environment through regular cleaning of equipment, sterilizing medical instruments, cleaning exam rooms and storage area; notifies staff member regarding ordering supplies and assists with stocking supplies;

assists with restocking exam rooms; performs basic maintenance;

notifies support staff regarding any necessary repairs.

I. Follow manufacturer’s recommendations and OSHA guidelines in handling hazardous substances.

J. Responsible for the proper collection of specimens, related paperwork, and delivery of specimens to the appropriate place.

K. Assist providers with physical exam acting as a third party in

L. Assist with special procedures as necessary.

3.2.10.2. Minimum Qualifications:

A. Four years of experience as a Medical Assistant or Certified

Med…