Exhibit-F-ScopeofWork.pdf

Scope of Work

The medical surveillance services provided must include, but are not limited to, the following:

1. Conduct baseline, periodic, and follow-up medical surveillance examinations which are appropriate to the individual's job duties. Conduct an exit examination when personnel are retiring, terminating employment, or moving to an Washington State Ferries (WSF) position that has no potential for exposures to hazardous materials.

2. All medical surveillance services, including examinations, must be conducted within a reasonable distance from the employee’s assigned duty station. Washington State Ferries duty stations include Anacortes, Bainbridge Island, Bremerton, Clinton, Coupeville, Edmonds, Kingston, Mukilteo, Port Orchard, Port Townsend, San Juan Islands, Seattle, Tacoma and Vashion Island

3. Examination scheduling must permit flexible scheduling by the employee during the work week.

4. All medical surveillance services must be conducted within a reasonable distance from the employee’s assigned duty station and permit flexible exam scheduling by the employee during the work week.

5. Maintain a current and complete copy of all employee medical surveillance records for Washington State Ferries (see “Records and Information Handling” section below).

6. Manage the examination schedule and communication for all WSF workers enrolled in the medical surveillance program.

a) Issue electronic exam notices at least 90 days before the worker's next examination is due.

b) Inform employees during scheduling that any medical condition identified during the medical surveillance examination which is not related to workplace exposure is the responsibility of the employee.

c) If a worker becomes overdue, notify the employee, their supervisor, and the WSF Safety Office electronically.

d) Follow up with the employee as needed to address overdue status or if additional information or testing is required.

e) Use supervisor information provided by WSF for necessary coordination.

7. Send a complete written medical report or summary of the medical surveillance examination and test results to the individual employee within 60 days of the examination. The report must be signed by the reviewing physician.

8. Provide a copy of the physician's written opinion or clearance letter to both the employee and the WSF Safety Office within 60 days of the examination. The letter must include any applicable restrictions, limitations, or recommendations regarding the employee's ability to perform assigned work, use a respirator, and/or wear personal protective equipment while carrying out job duties.

9. Maintain a procedure for providing prescriptive occupational exposure consultations, using appropriate reference materials as needed and qualified medical staff for all consultations.

A. Medical Surveillance Examinations:

1. All medical examinations and evaluations must be performed by or under the supervision of a licensed physician who is board certified in occupational medicine.

2. Employees must be informed during their medical surveillance examinations that any medical condition identified which is not related to workplace exposure is the responsibility of the employee. The contractor must clearly communicate that while Washington State Ferries covers the cost of the initial medical surveillance examination, any further evaluations, treatments, or tests recommended by the examining physician for non-workplace-related conditions are not covered by Washington State Ferries. Employees should be advised to follow up with their personal healthcare provider for such concern.

3. Conduct initial baseline, periodic, and follow up medical surveillance examinations or evaluations that include the following for each enrolled worker:

a. A medical and work history, with an emphasis on symptoms related to handling hazardous substances and health hazards.

b. An assessment of fitness for duty, including the ability to wear personal protective equipment under expected workplace conditions.

c. Confirmation or adjustment of the individual’s periodic examination frequency based on their medical condition, current job duties, and exposure history.

d. Any additional information deemed necessary by the examining physician.

e. An evaluation of what is needed for an employee baseline exam if the employee has had a recent medical surveillance exam and provides current medical surveillance records from previous employment.

f. An exit examination for personnel retiring, terminating employment, or transferring to an Washington State Ferries position with no potential for exposure to hazardous materials.

4. Provide medical surveillance services for the following personnel:

a. Shipyard Workers

b. Engine Crew

c. Deck Crew

d. Asbestos Team

B. Records and Information Handling:

Contractor will:

1. Maintain all employee medical surveillance medical records for Washington State Ferries in accordance with Chapter 296-802 WAC, Employee Medical and Exposure Records. These records must be maintained within the continental United States.

2. Provide an employee's medical surveillance medical records upon their request within 15 calendar days. When requested by the employer, provide non-confidential records, such as clearance letters or other job-related documentation, within the same timeframe, ensuring no personal health information is disclosed.

3. Verify that each medical surveillance participant is a current employee of Washington State Ferries and authorized to participate in the program.

4. In the event that an employee is treated by another medical provider for an exposure-related injury or illness, maintain established protocols for exchanging or obtaining medical information, coordinating follow-up care, and handling patient cases. Include any employer notification plan, specifying what information will be provided, if applicable

C. Reports:

The contractor is responsible for submitting the following reports. WSF reserves the right to request additional reports related to various aspects of the contract.

1. Provide verification that the medical surveillance exam was conducted for each participant.

2. Submit a written opinion or clearance letter from the examining physician that includes the following for each medical surveillance participant:

a. Confirmation of whether the employee has any detected or known medical conditions that would increase their risk of impairment during work related to working with hazardous chemical or respirator use.

b. Any recommended limitations on the employee’s assigned work.

c. A statement confirming the physician has informed the employee of the medical examination results and any medical conditions requiring further examination or treatment, whether by the medical surveillance provider or a personal physician.

d. Any recommendations for changing the medical surveillance exam frequency or for non-routine follow-up examinations or evaluations.

e. Submission of this document to the WSF Health and Safety Office, with a copy provided to the employee, within 60 days of the examination.

3. Provide the results of all tests and examinations directly to the employee.

4. Upon request, provide a report to Washington State Ferries on the status of the medical surveillance program, including any significant findings or recommendations related to the Washington State Ferries medical surveillance program and its employee participants.

D. Training:

At Washington State Ferries request, the contractor must provide orientation or training presentations to Washington State Ferries, with the participation of the contractor’s medical staff, to describe and explain the services provided in accordance with the contract and established protocols. Washington State Ferries may also request additional training to facilitate effective program implementation. This may include, but is not limited to, instructions on using the contractor’s software, identifying appropriate points of contact, accessing records, providing supervisor information, and other relevant processes.